Wednesday, March 11, 2015

TAVR you have a good chance of dying within 3 years, at least a 24% chance within the first year

Fewer people are getting coronary artery stents, so TAVR is the new cash cow for interventional cardiologists.

26% 1-year death, stroke rate after TAVR

Causes and timing of death during long-term follow-up after transcatheter aortic valve replacement - American Heart Journal

Here's an article about how hospitals in their advertising for TAVR downplay the risks.
U.S. hospitals tout TAVR's benefits, downplay risks
By: MITCHEL L. ZOLER. Cardiology News Digital Network Jan 13, 2015
If patients seek out information online about transcatheter aortic
valve replacement, they'll read mostly about the procedure's benefits
and see much less about its risks, according to a survey of 317 U.S.
hospital websites done in spring 2014.
Close examination of the information available for transcatheter aortic
valve replacement (TAVR) on the websites of U.S. hospitals that perform
the procedure revealed that 99% of the 262 hospitals with websites that
described TAVR mentioned at least one benefit from the procedure, while
26% mentioned at least one risk, Dr. Mark D. Neuman and his associates
reported in a research letter published online on Jan. 12 (JAMA Internal
Medicine 2015:[doi:10.1001/jamainternmed.2014.7392]).
"Our findings suggest that web-based advertising of TAVR to the public
by hospitals may understate the established risks of this procedure and
provide little context for the magnitude of those risks to inform patient
decisionmaking. Hospitals may promote appropriate use of TAVR by
presenting more balanced information regarding TAVR's risks and benefits,"
wrote Dr. Neuman, an anesthesiologist at the University of Pennsylvania
in Philadelphia, and his coauthors.
During May-June 2014 they reviewed the websites for each of the 317 U.S.
hospitals listed as sites that offer TAVR by the Society of Thoracic
Surgeons and the American College of Cardiology. Fifty-five of the
hospitals' websites did not have their own English-language web page
that mentioned TAVR. Of the 262 U.S. TAVR centers with a web page that
described the procedure, 260 mentioned at least one benefit, most
commonly the reduced degree of invasiveness of the procedure compared with
open-surgery valve replacement, which appeared on 250 (95%) of the websites.
Of the 69 websites that mentioned at least one risk, they most commonly cited
stroke, on 18% of the sites, followed by vascular complications, on 14%, and
death, on 12%. In addition, the hospital sites supplied numerical
quantification for benefits more frequently than for risks.
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