Over time, TAVR complications have declined—except for stroke.
Despite clinical and technological advancements, the rate of reported perioperative stroke is holding steady at 2-4%.1-6
Devastating patient impact
It is impossible to predict which procedures will dislodge embolic debris, and when it will cause disabling stroke.
Stroke is the leading cause of permanent disability – the long-term effects are serious including impaired ability to communicate and restricted physical abilities. It is also a primary risk factor for future clinical stroke, dementia, cognitive decline, and mortality.
Disabling stroke: physical effects¹⁰
The cost of stroke
For hospitals, the financial implications of all stroke include extended inpatient care, rehabilitation, and follow-up care.
The high cost of disabling stroke
Disabling stroke substantially increases both short- and long-term treatment costs.
For patients, the need for long-term care, skilled nursing, and rehabilitation facilities drives up costs by as much as 121%.
REFERENCES
1. Manoharan G, et al., J Am Coll Cardiol Intv 2015; 8:1359-67.
2. Wendler O, et al., Circulation 2017; 135: 1123–1132.
3. Seeger J, et al., Eur Heart J. 2018 Dec 24. doi: 10.1093/eurheartj/ehy847.
4. Haussig S et al., JAMA 2016; 316:592–601.
5. Kapadia S, Kodali S, Makkar R, et al., Protection against cerebral embolism during transcatheter aortic valve replacement. JACC. 2017; 69(4): 367–377.
6. Kapadia, et al. New England Journal of Medicine, 387(14), 1253–1263. Sep 2022.
7. Tsao CW, et al. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association external icon. Circulation. 2022;145(8):e153–e639.
8 Audience survey, Hawkey M, presented at ACC 2016
9. Coylewright M, Palmer R, O’Neil E, et al., Patient-defined goals for the treatment of severe aortic stenosis: A qualitative analysis. Health Expect. Oct 2016:19(5): 1-36-1043.
10. American Stoke Association: The Effects of Stroke. Available at: www.stroke.org
11. Alqahtani F, et al. Clinical and economic burden of acute ischemic stroke following transcatheter aortic valve replacement. Structural Heart. 2018;3(1):72:73.
12. Reddy et al. Time to Cost-Effectiveness Following Stroke Reduction Strategies in AF Warfarin Versus NOACs Versus LAA Closure. JACC Vol. 66, No. 24, December 22, 2015
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