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Objectives <p>The indications for transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis (AS) are gradually expanding in Japan, with insurance coverage for low-risk patients approved in 2021. Although some reports have compared procedural costs, data addressing low-risk populations remain limited. This study aimed to assess in-hospital costs and outcomes of isolated TAVR versus surgical aortic valve replacement (SAVR) in low-risk patients with AS in real-world practice in Japan.</p> Methods <p>We retrospectively analyzed 128 low-risk (Society of Thoracic Surgeons [STS] score &lt; 4%) patients with AS who underwent isolated TAVR (n = 80) or SAVR (n = 48) between August 2021 and December 2024 at The University of Osaka Hospital.</p> Results <p>Both groups achieved excellent outcomes, with no in-hospital or 30-day mortality. Patients who underwent TAVR had shorter intensive care unit (ICU) stays (1 [1–1] vs. 3 [2–4] days) and shorter postoperative stays (7 [5–11] vs. 14 [11–18] days). However, total in-hospital and combined operative plus postoperative costs were significantly higher for TAVR (5.62 vs. 5.11 million Japanese Yen (JPY), <i>p</i> &lt; 0.0001), (5.29 million vs. 4.80 million JPY, p = 0.0002).</p> Conclusions <p>In this cohort of low-risk patients with AS in Japan, TAVR was associated with significantly higher in-hospital costs than SAVR, despite shorter postoperative stay.</p>

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Hospital procedural costs of surgical aortic valve replacement versus transcatheter aortic valve replacement in low-risk isolated aortic stenosis: a single-center analysis in japan

  • 期刊论文

  • 发表日期：

    2025年12月19日

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  • Kunitaka Kumagai,
  • Koichi Maeda,
  • Kyongsun Pak,
  • Yusuke Misumi,
  • Kizuku Yamashita,
  • Ai Kawamura,
  • Daisuke Yoshioka,
  • Kazuo Shimamura,
  • Yasushi Yoshikawa,
  • Shigeru Miyagawa

摘要

Objectives

The indications for transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis (AS) are gradually expanding in Japan, with insurance coverage for low-risk patients approved in 2021. Although some reports have compared procedural costs, data addressing low-risk populations remain limited. This study aimed to assess in-hospital costs and outcomes of isolated TAVR versus surgical aortic valve replacement (SAVR) in low-risk patients with AS in real-world practice in Japan.

Methods

We retrospectively analyzed 128 low-risk (Society of Thoracic Surgeons [STS] score < 4%) patients with AS who underwent isolated TAVR (n = 80) or SAVR (n = 48) between August 2021 and December 2024 at The University of Osaka Hospital.

Results

Both groups achieved excellent outcomes, with no in-hospital or 30-day mortality. Patients who underwent TAVR had shorter intensive care unit (ICU) stays (1 [1–1] vs. 3 [2–4] days) and shorter postoperative stays (7 [5–11] vs. 14 [11–18] days). However, total in-hospital and combined operative plus postoperative costs were significantly higher for TAVR (5.62 vs. 5.11 million Japanese Yen (JPY), p < 0.0001), (5.29 million vs. 4.80 million JPY, p = 0.0002).

Conclusions

In this cohort of low-risk patients with AS in Japan, TAVR was associated with significantly higher in-hospital costs than SAVR, despite shorter postoperative stay.