It's heart to see: an early Health Technology Assessment towards using 3D-imaging prior to Transcatheter Aortic Valve Implantation

BACKGROUND: Patients undergoing heart surgery are examined using a combination of imaging modalities. New types of technology are able to convert CT, MRI and ultrasound images into a 3-Dimensional object, to look at the image from different angles and get a cross-sectional view of the heart. The use of 3D-imaging is not yet common for cardiac surgery. METHOD: The aim of this study is to investigate the potential effect of 3D-imaging on the outcome of TAVI procedures using a Discrete Event Simulation Model. Input data for the model is obtained from individual patient data, data gaps are filled in with the use of Expert Elicitation. Both deterministic and probabilistic sensitivity analysis is done to assess uncertainty RESULTS: Results showed that TAVI costs could potentially be reduced with €686 and the system itself costs €180 per patient. The expected cost savings equal €506 per TAVI. Sensitivity analysis showed that the amount of successful valve implementations has the most influence on cost-savings. The probability of 3D-imaging reducing costs is 74%. CONCLUSION: Using 3D-imaging prior to TAVI procedures has a favourable Cost-Benefit Ratio. However, it is still uncertain whether costs would be saved, and if so, how large cost savings would be.