Transcatheter aortic valve implantation (TAVI) and transcatheter mitral
valve repair (TMVR) are increasingly used for managing patients with
valvular heart disease to whom surgery presents a high-risk. As these
are costly procedures, a systematic review of studies concerned with
their economic assessment was undertaken. The search was performed in
PubMed and the Cochrane Library and followed recommended methodological
steps. Studies were screened and their data were retrieved and were
synthesized using a narrative approach. Twenty-four, good to high
quality, evaluations were identified, representing different viewpoints,
modelling techniques and willingness-to-pay thresholds. Studies show
that in high-risk patients with symptomatic aortic stenosis, TAVI may be
cost-effective compared with medical management (MM) across many health
care settings. In contrast, studies of TAVI compared with surgical
aortic valve replacement (SAVR) yield conflicting and inconclusive
results. The limited data available show that TMVR may also be
cost-effective relative to MM in mitral valve disease. Existing evidence
indicates that transcatheter techniques may be cost-effective options,
relative to MM, in high-risk patients with valvular disease.
Nonetheless, more research is needed to establish their economic value
further, to investigate the drives of cost-effectiveness, and to
evaluate surgical with transcatheter techniques in aortic valvular
disease