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Canadian Journal of Cardiology

Dissecting Aortic Stenosis Disparities in Ontario, Canada: Do Gaps Persist in the Transcatheter Era?

  • Dominique Vervoort
    Correspondence
    Corresponding author: Dr Dominique Vervoort, Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario M5T 3M6, Canada. Tel.: +1-416-989-7874.
    Affiliations
    Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

    Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada
    Search for articles by this author
  • Derrick Y. Tam
    Affiliations
    Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

    Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada
    Search for articles by this author
  • Stephen E. Fremes
    Affiliations
    Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

    Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada

    Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    Search for articles by this author
Published:October 28, 2022DOI:https://doi.org/10.1016/j.cjca.2022.10.025
      The growing awareness of and willingness to manage aortic valve disease has resulted in an increase in aortic valve procedures. In recent years, transcatheter aortic valve replacement (TAVR) has increasingly and sequentially been adopted in high-risk, intermediate-risk, and even low-risk surgical patients requiring aortic valve replacement. Although surgical aortic valve replacement (SAVR) remains the procedure of choice in lower-risk patients, TAVR has been used with optimal outcomes in these patients,
      • Tam D.Y.
      • Vo T.X.
      • Wijeysundera H.C.
      • et al.
      Transcatheter vs surgical aortic valve replacement for aortic stenosis in low-intermediate risk patients: a meta-analysis.
      with potential economic benefits over time as a result of shorter intensive care unit and hospital lengths of stay and improved early recovery.
      • Sud M.
      • Tam D.Y.
      • Wijeysundera H.C.
      The economics of transcatheter valve interventions.
      In the United States, TAVR volumes surpassed SAVR volumes,
      • Vemulapalli S.
      • Carroll J.D.
      • Mack M.J.
      • et al.
      Procedural volume and outcomes for transcatheter aortic-valve replacement.
      although this trend has not yet been observed in Canada.
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