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Methods: We examined the percentage of Medicare beneficiaries aged 80\u201390\u00a0years that require coronary access [percutaneous coronary intervention (PCI) or angiogram] in the 8\u00a0years following their TAVR using data from the Medicare 5% Standard Analytic File (2011\u20132021). The need for coronary access in older patients was estimated for all TAVRs, TAVR patients with and without a history of PCI, and TAVR patients with and without coronary artery disease (CAD) using time-to-event models adjusted for age, sex, race, region, ECI score, concomitant CABG, CAD, PCI, and current or recent smoker status. Multivariate log-gamma regressions were used to estimate the total cost of hospitalizations requiring coronary access post-TAVR. Results: A total of 6845 patients met inclusion criteria. The incidence rates for undergoing PCI or angiogram at 1, 3, 5, and 8\u00a0years were 1.9%, 4.0%, 5.5%, and 6.3%, respectively. TAVR patients with PCI demonstrated higher rates of coronary intervention compared to those without PCI (10.2% vs. 6.2% at 8\u00a0years, respectively). Similarly, TAVR patients with a prior CAD diagnosis exhibited increased rates of coronary intervention compared to those without a prior CAD diagnosis (7.4% vs. 2.1% at 8\u00a0years, respectively). The mean adjusted cost of hospitalizations requiring coronary access was $30,170 [95% Confidence Interval: $27,865-$32,665]. Conclusions: Approximately 6.8% of older TAVR patients require coronary access in the 8\u00a0years following their index procedure. The presence of a prior PCI or CAD diagnosis is associated with an increased requirement for subsequent coronary access.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s12928-025-01171-0","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T11:02:27Z","timestamp":1752836547000},"page":"900-908","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The need for future coronary access in older medicare beneficiaries following transcatheter aortic-valve replacement"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0764-973X","authenticated-orcid":false,"given":"Christopher","family":"Brown","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Kelley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace","family":"Gunnarsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"James","family":"Hermiller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"1171_CR1","doi-asserted-by":"publisher","first-page":"3579671","DOI":"10.1155\/2019\/3579671","volume":"2019","author":"AN Ferreira-Neto","year":"2019","unstructured":"Ferreira-Neto AN, Puri R, Asmarats L, et al. 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