Valve Disease

As many as 11.6 million Americans in the U.S. have heart valve disease (HVD), and more than 1 in 10 adults ages 75 and older have HVD. Thankfully, the HVD field has experienced tremendous advances in improving survival, recovery, and quality of life for patients.

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    • The rate of hospitalization from heart failure before and after transcatheter mitral valve repair (TMVR) decreases 73% (per patient year) in patients at prohibitive surgical risk.
       
    • The volume of mitral valve surgical procedures increased approximately 8.3% from 2010 to 2013.
       
    • The annual total incremental per patient health care expenditures for heart valve disease patients ranged from $1,755 in 1996 to $12,789 in 2011.
       
    • Pulmonary hypertension is a complication in at least 23% of patients with significant mitral regurgitation due to flail leaflet, and approximately doubles the risk of death and heart failure after diagnosis.
       
    • Mitral regurgitation patients who did not undergo surgery saw an increased use of medical therapies from 12% to 47% over 4.5 years.
       
    • Hospital Discharges from Heart Valve Disease in 2010*
       
    • Moderate or severe aortic valve disease is present in 4.2% to 10.7% of the population ages 65 and older.
       
    • Mitral valve disease is present in 5.1% of the population ages 65 and older.
       
    • Risk of heart valve disease increases with age
      Between the ages of 18 and 44, less than 1% of the U.S. population has heart valve disease. This increases to 8.5% between ages 65 and 74, and 13.2% after…  
    • Prevalence estimates for heart valve disease are likely low.
      A U.K. population screening found previously undetected heart valve disease in 1 in 2 adults ages 65+.  
    • Aortic stenosis often undertreated
       
    • >40% of heart murmurs missed by family practitioners
       
    • 6 in 10 heart valve patients didn’t have or recognize symptoms
       
    • >2/3 of heart valve disease patients knew little to nothing about it before their diagnosis
       
    • 30% of Americans ages 65+ know nothing about heart valve disease
       
    • 3 out of 4 Americans know little to nothing about heart valve disease
       
    • Projections of significant heart valve disease in 65+ U.K. population
       
    • TAVR improves quality of life in SAS patients
       
    • Survival rates of patients ages 65-75 with valve repair and replacement
       
    • From approval in 2011 through 2015 >54,000 TAVRs were performed in 418 centers in 48 states
       
    • Patients with severe MR who don’t have surgery have mortality rates of 20% after 1-year and 50% after 5-years
       
    • Every year more than 25,000 Americans die of heart valve disease
       
    • Survival rates of SAS patients ages 80+ with and without SAVR
       
    • In 2010, ~67,500 SAVRs were performed in the U.S.
       
    • Satisfaction rates of heart valve disease patients with their treatment
       
    • Survival rates for SAS patients without treatment
       
    • Medicare patients with sSAS have an average lifespan of 1.8 years without repair or replacement
       
    • Survival rates for patients with sSAS without repair or replacement
       
    • Total medical costs per patient with medically managed SAS
       
    • Total cost of heart valve disease in the U.S.
       
    • Prevalence of heart valve disease
       
    • ~8.7 to 11.6 million people in the U.S. have heart valve disease
      Alliance for Aging Research generated statistics, based on year 2000 percentage prevalence estimates by Nkomo et al. 2006 AND Bach et al. 2007 AND U.S. Census 2016  
    • Mitral valve disease costs
      Mitral valve disease (symptomatic and asymptomatic) costs the U.S. at least $13.2 billion in direct healthcare expenditures each year.  
    • Cost-effectiveness of TAVR in sSAS patients
      Patients with severe symptomatic aortic stenosis (sSAS) considered to be at high surgical risk who underwent transcatheter aortic valve replacement (TAVR) experienced lifetime incremental cost-effectiveness ratios of $55,090 per QALY…  
    • Cost-effectiveness of SAVR
      The cost-effectiveness ratio for surgical aortic valve replacement (SAVR), compared to no surgery, was estimated at $13,528 per quality-adjusted life year (QALY) (~$17,225 in 2017 dollars).  
    • Life expectancy and quality of life gains from AVR
      A study of 4,617 patients who underwent aortic valve replacement (AVR) over a period of 20 years found significant gains in life expectancy and quality of life — 43,166 net life-years…  
    • Disease specific status and generic health status improvements from TAVR and SAVR
      Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in intermediate risk symptomatic aortic stenosis (SAS) patients were associated with significant improvements in disease specific status (16 to…  
    • Satisfaction with HVD Treatment
      Among treated heart valve disease (HVD), 96% express “full satisfaction” and 78% are “very satisfied” with their treatment.  
    • Improvements in QoL from TAVR in SAS patients
      Symptomatic aortic stenosis (SAS) patients who underwent transcatheter aortic valve replacement (TAVR) experienced quality of life (QoL) improvements from 5.3 at baseline (10 point scale with 10=best imaginable health state)…  
    • TAVR Success in sSAS Patients
      A study of severe symptomatic aortic stenosis (sSAS) patients who received transcatheter aortic valve replacement (TAVR) found 30-day mortality of 2.2% for those who were high risk of surgical mortality/inoperable,…  
    • TAVR Procedures 2011 – 2015
      From approval in 2011 through 2015, >54,000 transcatheter aortic valve replacements (TAVRs) were performed in 418 centers in 48 states.  
    • TAVR v. SAVR in Intermediate-Risk SAS Patients
      At 1-year, severe aortic stenosis (SAS) patients with intermediate surgical mortality risk who underwent transcatheter aortic valve replacement (TAVR), had all-cause mortality rates of 7.4% (compared to 13% for surgical…  
    • Survival Rates of SAS Patients with and without SAVR
      Patients with severe aortic stenosis (SAS) ages 80+ who underwent surgical aortic valve replacement (SAVR) have 1-year, 2-year, and 5-year survival rates of 87%, 78%, and 68% respectively — compared with…  
    • Surgical Aortic Valve Replacements in 2010
      In 2010, ~67,500 surgical aortic valve replacements (SAVR) were performed in the U.S.  
    • 2016 prevalence of Americans 65+ who had AVD
      In 2016, an estimated 5.2 million U.S. adults ages 65+ had aortic valve disease (AVD).   Note: Alliance for Aging Research generated statistic, based on 2005 percentage prevalence estimates by Bach et al. 2007  
    • 2016 prevalence of aortic valve disease in America
      In 2016, as many as 5.8 million U.S. adults had aortic valve disease (AVD). Note: Alliance for Aging Research generated statistic, based on 2005 percentage prevalence estimates by Bach et al. 2007  
    • Undertreatment of patients with sSAS
      AS is often undertreated — one study found that 56% of severe symptomatic aortic stenosis (sSAS) patients referred to a cardiothoracic surgeon were not operated on.  
    • Detection rate of heart murmurs
      More than 40% of heart murmurs — detected with a stethoscope and sometimes the first sign of heart valve disease (HVD) — are missed by family practitioners.  
    • Many cases of HVD are diagnosed during a routine physical check-up
      Six in 10 patients did not have or recognize symptoms of heart valve disease (HVD) and were only diagnosed after going to their doctor for a regular check-up or a…  
    • HVD patients knew little prior to their diagnosis
      More than 2/3 of valve disease patients knew a limited amount or nothing about heart valve disease (HVD) before their diagnosis.  
    • Many Americans know nothing about HVD
      Of those Americans surveyed ages 65+, 30% know nothing about heart valve disease (HVD).  
    • American knowledge of HVD
      A survey of Americans found that only 1 in 4 know “somewhat” or a “great deal” about heart valve disease (HVD). Forty percent know nothing about the disease.  
    • Projections of Significant Heart Valve Disease — Diagnosed & Undiagnosed — in the 65+ U.K. Population
       
    • Five-year health care resource use in medically managed SAS patients
       
    • Mean 5-Year Cumulative Total Medical Costs Per Medically Managed (No AVR) Severe AS Patient
       
    • SAS patient hospitalization costs
      Symptomatic aortic stenosis (SAS) patients who do not undergo treatment cost Medicare as much as $1.3 billion each year due to rehospitalization, prolonged stays, admissions to skilled nursing facilities, and…  
    • Aortic valve disease costs
      Aortic valve disease (AVD) (symptomatic and asymptomatic) costs the U.S. $10.2 billion in direct costs each year.  
    • Survival Rates Over 5 Years for Patients with Medically Managed Severe Aortic Stenosis
       
    • Increased hospital admissions and prolonged length of stay for patients who do not undergo treatment
      Medicare severe symptomatic aortic stenosis (sSAS) patients who do not undergo treatment have an average of 1.9 hospital admissions per year and prolonged lengths of stay — 11.5 hospital days…  
    • All-cause mortality for aortic valve disorders
      In 2014, all-cause mortality for aortic valve disorders was 34,408 in the U.S.  
    • 1 and 6-month mortality rates without treatment for sSAS
      Waiting for treatment for severe symptomatic aortic stenosis (sSAS) can be deadly, with 1-month mortality at 3.7% and 6-month mortality at 11.6% (measured from the time intervention was recommended).  
    • Lifespan of Medicare patients with sSAS who do not undergo treatment
      Medicare patients with severe symptomatic aortic stenosis (sSAS) who do not undergo treatment have an average lifespan of 1.8 years.  
    • Survival rates of sSAS patients who do not undergo valve replacement
      Patients with severe symptomatic aortic stenosis (sSAS) who do not undergo valve replacement have survival rates as low as 50% at two years and 20% at 5 years after the…  
    • Prevalence of AS in Americans 75+
      An estimated 12.4%, or ~2.5 million people ages 75+ in North America, have AS.  
    • Low detection rates for AS
      Prevalence estimates for AS are likely low. A U.K. population screening found previously undetected HVD in 1 in 2 adults ages 65+.  
    • Aortic stenosis impacts majority of heart valve disease patients
      Aortic stenosis (AS) is among the most common forms of heart valve disease (HVD), affecting 2% to 3% of the adult U.S. population.