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Transcatheter Aortic Valve Implantation pp 201–212Cite as

Implementation Issues for Transcatheter Aortic Valve Implantation: Access, Value, Affordability, and Wait Times

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Abstract

Transcatheter aortic valve replacement (TAVR) has rapidly transitioned from an innovative procedure intended for compassionate use to the standard of care for elderly patients with severe aortic stenosis. With the growth in the indications for TAVR, demand for this procedure has grown exponentially. This growth has put pressure on funding and infrastructure. In this chapter, we examine these implementation issues through an examination of disparities in access to TAVR, reimbursement concerns related to TAVR value and affordability, the impact of the imbalance between demand and supply in terms of wait times, the consequences of prolonged wait times, and finally the complexities associated with addressing infrastructure limitations.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

    Harindra C. Wijeysundera & Gabby Elbaz-Greener

  2. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Harindra C. Wijeysundera, Derrick Y. Tam & Stephen E. Fremes

  3. Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada

    Harindra C. Wijeysundera

  4. Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

    Derrick Y. Tam & Stephen E. Fremes

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  1. Harindra C. Wijeysundera
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  2. Gabby Elbaz-Greener
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  3. Derrick Y. Tam
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  4. Stephen E. Fremes
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Correspondence to Harindra C. Wijeysundera .

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Editors and Affiliations

  1. Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy

    Arturo Giordano

  2. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy

    Giuseppe Biondi-Zoccai  & Giacomo Frati  & 

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Wijeysundera, H.C., Elbaz-Greener, G., Tam, D.Y., Fremes, S.E. (2019). Implementation Issues for Transcatheter Aortic Valve Implantation: Access, Value, Affordability, and Wait Times. In: Giordano, A., Biondi-Zoccai, G., Frati, G. (eds) Transcatheter Aortic Valve Implantation. Springer, Cham. https://doi.org/10.1007/978-3-030-05912-5_17

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