Heart valve procedure safe for most patients, but CMS still restricts coverage

A wider range of patients could benefit from transcatheter aortic valve replacement than previously thought, according to two studies published March 16 in The New England Journal of Medicine and cited by The New York Times.

Five things to know:

1. TAVR is a minimally invasive heart procedure historically reserved for patients who are too sick or old to undergo open-heart surgery. However, new research suggests younger, healthier patients with failing heart valves may also benefit from TAVR.

2. The studies showed similar or lower mortality, stroke and readmission rates among TAVR patients compared to open-heart surgery patients. Edwards Lifesciences and Medtronic, which manufacture replacement heart valves, funded the studies.

"[The findings] shift our thinking from asking who should get TAVR to why should anyone get surgery," Howard Herrmann, MD, director of interventional cardiology at the Philadelphia-based Hospital of the University of Pennsylvania, told NYT. Dr. Herrmann was not involved in either study.

3. Due to safety concerns, CMS limits Medicare reimbursement for TAVR to larger hospitals that perform at least 20 procedures annually. The agency only offers TAVR reimbursements to about 600 hospitals nationwide, according to The Wall Street Journal.

4. As a result, patients in rural areas often travel greater distances to undergo the procedure. Many rural physicians are urging CMS to cut volume requirements or make them more lenient. They argue medical advancements have made the procedure less risky.

5. CMS is expected to release new rules to dictate which physicians and hospitals can use TAVR by the end of March, according to WSJ.

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