Abstract
Introduction: In terms of a gentle, minimally invasive form of treatment Alain Cribier performed the first human transcatheter aortic valve implantation in 2002, followed by the group of Prof. Mohr in Leipzig with the transapical technique. TAVI has nowadays become a valid alternative in treatment of inoperable or high risk patients with severe aortic stenosis. 1,2,3The broad `Augsburg experience` of 5 years (2008-2013), with 232(n) cases treated with a transapical approach, has been analyzed closely in terms of results and clinical benefits (life expectancy, quality of life).Methods: As first step we performed a systematic review of available sources concerning techniques, outcomes and costs of transcatheter valve implantation. Then we performed a retrospective analysis of all our transapical cases (n:232) from 2008 to 2014. We also performed a cost-utility and an overall cost-effectiveness ratio evaluation comparing transcatheter valve implantation with standard therapy in high risk patients ineligible for conventional surgery.Conclusion: The introduction of catheter-based aortic valve implantation for high-risk patients provided very good clinical results in terms of outcomes and quality of life for our patients and additionally demonstrated a favourable cost-effectiveness ratio compared to non surgical standard in our clinical experience.The implementation of a TAVI-Program can imply clinical and economic advantages at several levels (health insurance, political economy) and should therefore be supported from our view.
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