{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T20:31:26Z","timestamp":1784233886813,"version":"3.55.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,6,15]]},"abstract":"\n Background<\/jats:title>\n Transcatheter aortic valve replacement (TAVR) has transformed the management of aortic valve stenosis. However, little national data are available characterizing the geographic and demographic dispersion of this disruptive technology relative to surgical aortic valve replacement (SAVR).<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n In this US claims\u2010based study, we analyzed a 100% sample of fee\u2010for\u2010service Medicare beneficiaries from 2012 to 2017 and examined national rates of TAVR versus SAVR. Procedure rates were compared across years as a function of age, sex, race, and geography for TAVR and SAVR beneficiaries. There was significant growth in TAVR from 15.4 beneficiaries\/100\u00a0000 enrollees in 2012 to 90.6 in 2017 (\n P<\/jats:italic>\n <0.001). SAVR rates declined from 92.8 beneficiaries\/100\u00a0000 enrollees in 2012 to 63.5 in 2017 (\n P<\/jats:italic>\n <0.001). The growth of TAVR varied as a function of age (\n P<\/jats:italic>\n <0.0001). While TAVR was the dominant strategy among beneficiaries \u226585 and 75 to 84\u00a0years old, SAVR was more common among beneficiaries 65 to 74\u00a0years old. TAVR was also used more frequently than SAVR among women (\n P<\/jats:italic>\n <0.001). While TAVR increased among all races, it was less commonly used among non\u2010White beneficiaries (\n P<\/jats:italic>\n <0.001). Contemporary use of TAVR relative to SAVR varied significantly by geographic location, with a TAVR:SAVR ratio in 2017 of 1.24 in the Midwest and 1.68 in the Northeast (\n P<\/jats:italic>\n <0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In 2017, the number of Medicare beneficiaries receiving TAVR exceeded SAVR for the first time in the United States. There is significant variation, however, in the geographic expansion of TAVR and in patient demographics relative to SAVR.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.120.019588","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T09:03:58Z","timestamp":1622451838000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Geographic and Demographic Variability in Transcatheter Aortic Valve Replacement Dispersion in the United States"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3178-8702","authenticated-orcid":false,"given":"Michael N.","family":"Young","sequence":"first","affiliation":[{"name":"Division of Cardiology Dartmouth\u2010Hitchcock Medical CenterGeisel School of Medicine at Dartmouth Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Kearing","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute of Health Policy and Clinical PracticeDartmouth College Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Malenka","sequence":"additional","affiliation":[{"name":"Division of Cardiology Dartmouth\u2010Hitchcock Medical CenterGeisel School of Medicine at Dartmouth Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip P.","family":"Goodney","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute of Health Policy and Clinical PracticeDartmouth College Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4760-9396","authenticated-orcid":false,"given":"Jonathan","family":"Skinner","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute of Health Policy and Clinical PracticeDartmouth College Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5939-564X","authenticated-orcid":false,"given":"Alexander","family":"Iribarne","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute of Health Policy and Clinical PracticeDartmouth College Lebanon NH"},{"name":"Division of Cardiac Surgery Dartmouth\u2010Hitchcock Medical CenterGeisel School of Medicine at Dartmouth Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.4449"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27018"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.040788"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1700456"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816885"},{"key":"e_1_3_2_9_2","volume-title":"Diffusion of Innovations","author":"Rogers E","year":"2003","unstructured":"Rogers E. Diffusion of Innovations. 5th ed. New York, NY: Simon and Schuster; 2003.","edition":"5"},{"key":"e_1_3_2_10_2","unstructured":"Decision memo for transcatheter aortic valve replacement (TAVR). Available at: https:\/\/www.cms.gov\/medicare\u2010coverage\u2010database\/details\/nca\u2010decision\u2010memo.aspx?NCAId=293. Accessed April 14 2020."},{"key":"e_1_3_2_11_2","unstructured":"Research Methods. Dartmouth Atlas of Health Care. Available at: https:\/\/www.dartmouthatlas.org\/research\u2010methods\/. Accessed April 14 2020."},{"key":"e_1_3_2_12_2","unstructured":"US Census Bureau . 2010 Census Regions and Divisions of the United States. The United States Census Bureau. Available at: https:\/\/www.census.gov\/geographies\/reference\u2010maps\/2010\/geo\/2010\u2010census\u2010regions\u2010and\u2010divisions\u2010of\u2010the\u2010united\u2010states.html. Accessed April 14 2021."},{"key":"e_1_3_2_13_2","unstructured":"Premarket Approval (PMA) . Edwards Sapien transcatheter heart valve and accessories. Available at: https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfpma\/pma.cfm?id=P100041. Accessed April 14 2020."},{"key":"e_1_3_2_14_2","unstructured":"Premarket Approval (PMA) . Medtronic Corevalve System. Available at: https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfpma\/pma.cfm?id=P130021. Accessed April 14 2020."}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.019588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:02:22Z","timestamp":1715598142000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.019588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,15]]},"references-count":13,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,6,15]]}},"alternative-id":["10.1161\/JAHA.120.019588"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.019588","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,15]]},"assertion":[{"value":"2020-10-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e019588"}}