TAVR technique have revolutionized the prognosis in fragile patients presenting severe aortic valve stenosis. The implantation of such expensive prosthesis in elderly and comorbid patients may be questionable at the era when health care costs are a major concern for everyone.

The objective of this study was to assess the cost-effectiveness of TAVR implantation in current real-life patients.

All consecutive patients eligible for transfemoral TAVR using Sapien-3^® bioprosthesis between September 2014 and December 2015 were prospectively included in this monocentric study. Three groups were constituted regarding the nationally-defined severity index of each patient. The primary clinical endpoint was the difference between costs and receipts, calculated for each patient at 30 days post-procedure. Secondary composite endpoints assessed the safety of the procedure and analyzed costs division.

A total of 189 patients were included in the analysis. Baseline characteristics were mostly similar between groups. At one-month post-TAVR, 3 patients were dead (2 from non-cardiac causes). The mean costs were 27967±2901€ per patient and receipts were 30312±2864€ per patient (P<0.001). The difference resulted in a significant benefit (2745±1479€ per patient). The main benefits were observed in patients presenting the lower severity-index. The device-related costs represented more than 80% of total costs (Figure 1).

In carefully selected patients, TAVR procedure was highly cost-effectiveness in an academic center, regardless of the patient's risk profile.