Newer heart valve replacement treatment increased in U.S. in wealthy, metro areas

Research Highlights:

• Despite the increase in the number of health centers in the U.S. performing the newer, minimally invasive heart valve procedure called TAVR (transcatheter aortic valve replacement), the expansion has not occurred equitably in communities across the country, according to new research published today in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.
• TAVR is a newer surgical procedure to replace a diseased valve in the heart. Through a catheter, a new replacement heart valve is placed inside the old, damaged valve and takes over the work of regulating blood flow in the heart. The procedure is a beneficial option for people who may not have been considered for traditional valve replacement via open-heart surgery because it is performed through small openings in the chest, leaving all the chest bones in place, thereby avoiding the lengthy recovery time and additional risks associated with open-heart surgery.
• In the study conducted by the University of Pennsylvania in Philadelphia, researchers found that during the initial growth phase of TAVR programs (health centers with trained staff and specialized equipment to provide TAVR) between 2012 and 2018, U.S. hospitals in wealthier communities (based on median income levels) and metropolitan areas were more likely to start TAVR programs, while hospitals in poorer or rural communities were less likely to start TAVR programs.
• The number of TAVR procedures were 1.19% lower for each 1% increase in patients with markers of lower socioeconomic status.
• The analysis indicates just over 98% of the new TAVR programs during the 6-year study period opened in metropolitan areas and were in metropolitan areas that had pre-existing TAVR programs 50% of the time.
• These findings highlight geographic and socioeconomic inequities in the growth and dispersion of the advanced TAVR procedure. The unequal introduction of this novel technology and treatment appears to be one factor contributing to health care inequities among socioeconomically disadvantaged people, the authors write.