Evidence map›Paper›PMID 25336467›Full record

Trial reportCirculation. Cardiovascular interventions2014

Costs of periprocedural complications in patients treated with transcatheter aortic valve replacement: results from the Placement of Aortic Transcatheter Valve trial.

Suzanne V Arnold, Yang Lei, Matthew R Reynolds, Elizabeth A Magnuson, Rakesh M Suri, E Murat Tuzcu, John L Petersen, Pamela S Douglas, Lars G Svensson, Hemal Gada and 6 more

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Cardiovascular interventions, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00530894 (THE PARTNER TRIAL), which is not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 1 pooled it
4.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00530894 nacompletednot on this map

THE PARTNER TRIAL: Placement of AoRTic TraNscathetER Valve Trial Edwards SAPIEN Transcatheter Heart Valve

TypeinterventionalSponsorEdwards LifesciencesRan2007 to 2017Enrolled1,057ConditionsCritical Aortic StenosisArmsEdwards SAPIEN Transcatheter Heart Valve, Surgical Valve Replacement, medical management and/or balloon aortic valvuloplasty
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 1 synthesis or guideline pooled it, 85 citations in OpenAlex.

  1. Pooled it
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  11. Review
  12. Observational
  13. Article
  14. Review
  15. Outcomes of stroke events during transcatheter aortic valve implantation.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022
    Article
  16. Article
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  18. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 6 institutions in 1 country.

Suzanne V ArnoldFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.). suz.v.arnold@gmail.com.
Yang LeiFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Matthew R ReynoldsFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Elizabeth A MagnusonFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Rakesh M SuriFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
E Murat TuzcuFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
John L PetersenFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Pamela S DouglasFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Lars G SvenssonFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Hemal GadaFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Vinod H ThouraniFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Susheel K KodaliFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Michael J MackFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
Martin B LeonFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
David J CohenFrom the Saint Luke's Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Mayo Clinic, Rochester, MN (R.M.S.); Cleveland Clinic Foundation, OH (E.M.T., L.G.S.); Swedish Medical Center, Seattle, WA (J.L.P.); Duke University, Durham, NC (P.S.D.); Columbia-Presbyterian Hospital, New York, NY (H.G., S.K.K., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); and Baylor Healthcare System, Plano, TX (M.J.M.).
PARTNER Investigators
University of Missouri–Kansas City · USEmory University · USSwedish Medical Center · USBaim Institute for Clinical Research · USPresbyterian Hospital · USCleveland Clinic · US

Funding

Optimal Decision Making in Aortic Valve ReplacementK23HL116799 · NHLBI · SAINT LUKE'S HOSPITAL · PI ARNOLD, SUZANNE VICTORIA · 2014 to 2018
$635k
NHLBI NIH HHS K23 HL116799
6 · The paper itself

Abstract

backgroundIn patients with severe aortic stenosis, transcatheter aortic valve replacement (TAVR) improves survival when compared with nonsurgical therapy but with higher in-hospital and lifetime costs. Complications associated with TAVR may decrease with greater experience and improved devices, thereby reducing the overall cost of the procedure. Therefore, we sought to estimate the effect of periprocedural complications on in-hospital costs and length of stay of TAVR. METHODS AND

resultsUsing detailed cost data from 406 TAVR patients enrolled in the Placement of Aortic Transcatheter Valve (PARTNER) I trial, we developed multivariable models to estimate the incremental cost and length of stay associated with specific periprocedural complications. Attributable costs and length of stay for each complication were calculated by multiplying the independent cost of each event by its frequency in the treatment group. Mean cost for the initial hospitalization was $79 619±40 570 ($50 891 excluding the valve); 49% of patients had ≥1 complication. Seven complications were independently associated with increased hospital costs, with major bleeding, arrhythmia, and death accounting for the largest attributable cost per patient. Renal failure and the need for repeat TAVR, although less frequent, were also associated with substantial incremental and attributable costs. Overall, complications accounted for $12 475 per patient in initial hospital costs and 2.4 days of hospitalization.

conclusionsIn the PARTNER trial, periprocedural complications were frequent, costly, and accounted for ≈25% of non-implant-related hospital costs. Avoidance of complications should improve the cost-effectiveness of TAVR for inoperable and high-risk patients, but reductions in the cost of uncomplicated TAVR will also be necessary for optimal efficiency. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00530894.

Indexed as

Hospital CostsAgedAged, 80 and overAortic Valve StenosisCardiac CatheterizationChi-Square DistributionComorbidityFemaleHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHospitalizationHospital MortalityHumansLength of StayLinear ModelsLogistic Modelsaortic valvecomplicationscosts and cost analysistranscatheter aortic valve replacement

Identifiers

PMID25336467
PMCPMC4270914
OpenAlexW2548384528

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.