Percutane hartklep implantatie bij congenitale en ... - KCE

KCE Reports vol Percutaneous Heart Valves 61
Device
Patient
Device
Patient
Table 7.2. Appropriateness, feasibility, safety and effectiveness of PHV insertion. Summary of discussion.
Procedure Clinical effectiveness
Appropriateness Feasibility Safety Early Late
unknown; depends on effectiveness of
PAV as compared to conventional
surgery
choice depends on patient's preference
whether to opt for conservative treatment
or for correction of the valvular
dysfunction (by any means)
safety as compared to
surgery unclear; 30-day
mortality 10-15% in the
hands of experienced team;
6-month mortality 20-30%
short term
hemodynamic
and clinical
performance
good
long term durability
unknown (but a lesser
issue, given the limited
life expectancy of
eligible patients)
Procedure Clinical effectiveness
Appropriateness Feasibility Safety Early Late
unknown; depends on effectiveness of
PPV as compared to conventional
surgery
conservative treatment is no option in
symptomatic patients; in asymptomatics,
timing of the intervention (by any means)
is unclear
Percutaneous aortic valve insertion (PAV)
feasible in 88-96%
of attempts in the
hands of
experienced team
Percutaneous pulmonary valve insertion (PPV)
feasible in 97% of
attempts in the
hands of one
single operator
early mortality 1,3% in
single operator experience
long term patient survival
unclear
unknown: as compared to surgery or
medical therapy, it depends on comorbidity
related QoL and co-morbidity
related life expectancy
short term
hemodynamic
performance
good
long term durability of
the valve unknown
long term effectiveness in postponing
surgery unknown
Cost Effect.
lack of input
data precludes
reliable
calculation of
ICERs
Cost Effect.
lack of input
data precludes
reliable
calculation of
ICERs