Cost-Effectiveness and Clinical Outcome of Transcatheter Versus Sutureless Aortic Valve Replacement

Background: Sutureless aortic valve replacement (SU-AVR) and transcatheter aortic valve implantation (TAVI) are becoming increasingly common. The aim of this study is to compare the clinical outcome and cost-effectiveness of the two methods. Methods: In this study, cross-sectional retrospective data were collected on 327 patients who un-derwent SU-AVR (n = 168) and TAVI (n = 159). Homo-geneous groups were provided by the "propensity score matching" method, and 61 patients from the SU-AVR group and 53 patients from the TAVI group were included in the study sample. Results: The two groups did not have sta-tistically different death rates, complications after surgery, lengths of hospital stays, or visits to the intensive care unit. It is stated that the SU-AVR method provides an additional 1.14 Quality-Adjusted Life Year (QALY) compared to the TAVI method. The TAVI was more expensive than the SU-AVR in our study, but the difference was not statistically significant ($40,520.62 vs. $38,405.62, p > 0.05). For SU-AVR, the most expensive factor was the length of stay in the intensive care unit; for TAVI, it was arrhythmia, bleed-ing, and renal failure. Conclusions: These bioprostheses are safe and effective treatments for valve stenosis. Clini-cal outcomes were similar between the two groups. There-fore, clinicians may find it difficult to determine an effec-tive treatment strategy. According to the evaluation made in terms of cost-effectiveness, it was found that the SU-AVR method gave a higher QALY at a lower cost compared to the TAVI method. However, this result is not statistically significant.