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Evidence to Improve Care

Transcatheter Aortic Valve Implantation for Treatment of Aortic Valve Stenosis

Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee recommends that transcatheter aortic valve implantation be publicly funded in patients with severe symptomatic degenerative aortic valve stenosis:

    • Who are not candidates for surgical aortic valve replacement or
    • Who have an estimated risk of mortality of 8% or greater within 30 days of surgery, as determined by a multidisciplinary cardiac team after evaluating the patient’s Society of Thoracic Surgeons risk assessment score and other patient characteristics.

  • The Ontario Health Technology Advisory Committee recommends that transcatheter aortic valve implantation be offered only in selected hospitals, as determined by the Cardiac Care Network of Ontario.

Read the full OHTAC Recommendation report

The aortic valve is one of four valves in the heart. Blood flows through the aortic valve when it is pumped from the left ventricle of the heart into the aorta (the main artery in the body). Aortic valve stenosis occurs if the valve narrows and cannot open all the way, partially blocking the flow of blood out of the heart. Severe aortic valve stenosis is a life-threatening condition that can lead to death, usually from heart failure.

Health Quality Ontario Reviews Transcatheter Aortic Valve Implantation

The diseased aortic valve can be removed and replaced with an artificial valve, but doing this involves open-heart surgery. Transcatheter aortic valve implantation, or TAVI, is a newer procedure. In most cases, cardiologists make a small opening in an artery near the groin to insert a catheter to deliver and implant the new valve. We reviewed the evidence that compared TAVI with surgical aortic valve replacement.

The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry is currently supporting transcatheter aortic valve implantation in selected high volume centres for the patient groups recommended by Health Quality Ontario

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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