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Evidence to Improve Care

Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Valve Stenosis at Low Surgical Risk

Final Recommendation

  • Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends publicly funding transcatheter aortic valve implantation in adults with severe aortic valve stenosis who are at low surgical risk

Read the final recommendation report



Aortic valve stenosis is a common heart disease. It’s when the aortic valve in the heart has narrowed, causing the heart to work harder to pump blood to the body.

The usual treatment replaces the damaged valve with an artificial one through open-heart surgery -- known as surgical aortic valve replacement. Another option, called transcatheter aortic valve implantation, is a less invasive procedure. This procedure goes through an artery, most commonly in the leg, to place an artificial valve inside the damaged one.

A previous health technology assessment reviewed this procedure for people who are at intermediate risk for surgery (which means at increased risk of dying within 30 days of a surgical valve replacement). This new health technology assessment looks at how safe and effective transcatheter aortic valve implantation is for people at low risk for surgery. We looked at whether this procedure is cost–effective and at the budget impact of publicly funding surgery for people at low risk levels. We also talked with people who have aortic stenosis, their families and caregivers to learn about their experiences, preferences and values.

The assessment was conducted in collaboration with the Canadian Agency for Drugs and Technologies in Health (CADTH). The Agency completed a rapid review of the qualitative evidence of patient preferences.

Read the full health technology assessment report for more information.


Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Valve Stenosis at Low Surgical Risk: A Health Technology Assessment (PDF)
November 2020

Related Resources
Transcatheter Aortic Valve Implantation for Aortic Stenosis: A Rapid Qualitative Review
Canadian Agency for Drugs and Technologies in Health (CADTH)
September 2019

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The Ministry of Health has accepted this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.



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