27 October, 2020

Guidance published: Transcatheter aortic valve implantation (TAVI)

Health Technology Wales has today published national Guidance on transcatheter aortic valve implantation (TAVI).

We appraised the clinical and cost effectiveness of TAVI for the treatment of patients with severe symptomatic aortic stenosis who are at intermediate surgical risk.

Our Appraisal Panel concluded that the cost effectiveness evidence does not currently support the case for routine adoption of TAVI.

TAVI was non-inferior to SAVR for all-cause mortality, cardiac mortality or disabling stroke, and shows similar improvements in both symptoms and quality of life. A cost-utility analysis showed that TAVI is unlikely to be cost effective in this patient group. The cost-effectiveness result was mainly driven by the cost of the TAVI valve.

Aortic stenosis (AS) is an obstruction of normal blood flow across the aortic valve. TAVI is an alternative procedure that can be used for people of an increased operable risk, and is currently a treatment option for inoperable or high surgical risk cases in Wales. We appraised this topic because more focus is turning to the use of TAVI in lower or intermediate risk populations.

The topic was suggested through the Welsh Health Specialised Services Committee (SHTG).

The status of our Guidance is that NHS Wales should adopt this guidance or justify why it has not been followed. We will evaluate the adoption and impact of our Guidance.

We’ve published Guidance, an Evidence Appraisal Report (EAR), a Topic Exploration Report and a plain language summary for this topic. Click here to read about this topic.

HTW Appraisal Panel considers appraisal evidence within the context of NHS Wales and produces the HTW Guidance. The panel also helps us to identify important topics, evaluates the uptake of guidance and facilitates stakeholder engagement. It has pan-Wales and multi-disciplinary representation. Learn more about our Appraisal Process.