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Percutaneous pulmonary and aortic valve insertion in Belgium: Going for conditional reimbursement or waiting for further evidence?

Published online by Cambridge University Press:  21 July 2009

Mattias Neyt ,
Imgard Vinck ,
Marc Gewillig  and
Hans Van Brabandt
Mattias Neyt
Affiliation:
Belgian Health Care Knowledge Centre
Imgard Vinck
Affiliation:
Belgian Health Care Knowledge Centre
Marc Gewillig
Affiliation:
University Hospital Gasthuisberg
Hans Van Brabandt
Affiliation:
Belgian Health Care Knowledge Centre
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Abstract

Objectives: The aim of this study was to assess current evidence supporting the use of percutaneous heart valves (PHV) in degenerative aortic valve and congenital pulmonary outflow tract disease, as compared to conservative medical therapy or traditional surgical valve replacement.

Methods: A systematic review of the literature on PHV was performed.

Results: No randomized controlled trials (RCT) on PHV have been published so far. Only observational data from series and data presented at cardiology meetings are available. Both percutaneous aortic valve (PAV) and percutaneous pulmonary valve (PPV) seem feasible in the hands of an experienced team. Safety, however, seems to be a problem in PAV, as shown by the high 30-day and 6-month mortality rates.

Conclusions: Due to safety concerns, PAV reimbursement is not recommended and patients should only be subjected to PAV insertion within the boundaries of an RCT. In contrast, PPV implantation seems to be a safe and promising technology for which reimbursement under strict conditions may be recommended.

Keywords

Heart valve prosthesisHeart valve prosthesis implantationTechnology assessmentBiomedical
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 3 , July 2009 , pp. 281 - 289
Copyright
Copyright © Cambridge University Press 2009

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