ArticleStructural heart : the journal of the Heart Team2026
The Clinical and Economic Consequences of Delayed Transcatheter Aortic Valve Replacement.
Article in Structural heart : the journal of the Heart Team, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Delays in access to aortic valve replacement, the recommended treatment for aortic stenosis (AS), is common; however, the impact of this delay is not clearly known. This study aims to examine the clinical and economic consequences of delayed transcatheter aortic valve replacement (TAVR) in patients with clinically significant AS. Methods: We analyzed 4069 patients with clinically significant AS who underwent TAVR between July 2019 and June 2023 using the Optum Market Clarity database. Patients were categorized as timely TAVR (≤90 days from diagnosis) or delayed TAVR (>90 days or urgent/emergent procedure). Clinical outcomes included all-cause mortality, heart failure hospitalizations, stroke, and composite endpoints over 3 years. Economic outcomes included total health care costs and hospitalization utilization. Multivariable Cox proportional hazards and generalized linear models were used for analysis. Results: Of 4069 patients, 2051 (50.4%) received timely TAVR and 2018 (49.6%) received delayed TAVR. Delayed patients had higher frailty scores (10.9 vs. 8.5; Conclusions: Delayed TAVR is associated with substantial clinical and economic consequences, including a 50% higher mortality risk and $36,740 in excess costs over 3 years. These findings support the importance of timely intervention and health care system investments to reduce TAVR wait times.
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