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Aortic Stenosis -The Unmet Need. Simon Ray University Hospitals of South Manchester. NO CONFLICT OF INTEREST TO DECLARE . Unmet Need – Lack of Data. No epidemiological data for the prevalence of valve disease in the UK

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aortic stenosis the unmet need

Aortic Stenosis -The Unmet Need

Simon Ray

University Hospitals of South Manchester

ACI 2009

unmet need lack of data
Unmet Need – Lack of Data
  • No epidemiological data for the prevalence of valve disease in the UK
  • No UK data on the number of patients with known symptomatic aortic stenosis not referred for surgery
  • No UK data on the number of patients referred for surgery but not operated

ACI 2009

unmet need us data
Unmet Need – US Data
  • Prevalence of moderate to severe aortic valve disease in the US population > 75 years 2.8%
  • English population > 75 years about 3.9M
  • About 110K individuals in England >75 years with moderate to severe AS
  • About 1200 AVR performed annually >75years
  • About 1.1% of affected population operated annually

ACI 2009

unmet need euro heart
Unmet Need – Euro Heart
  • Euro Heart Survey
    • About 1/3 older or comorbid patients not referred for surgery
  • For age >75 ‘surgical rejects’ alone:
    • 600 TAVI candidates per year in England
  • Assume some switch of ‘high risk’ > 75 patients to TAVI:
    • 10%; 720 per year
    • 20%; 840 per year

ACI 2009

unmet need scts data
Unmet Need – SCTS Data
  • SCTS data for high risk surgery in the UK
    • About 1500 per year over 80 or Euroscore > 10
    • Mortality about 10%
  • Assume 1/3 not referred and suitable for TAVI:
    • 750 TAVI for UK
  • Assume some switch of ‘high risk’ to TAVI
    • 10%; 900 TAVI per year for the UK
    • 20%; 1050 TAVI per year for the UK

ACI 2009

possible demand
Possible Demand
  • Relatively conservative estimates:
    • About 1000 TAVI per annum for the UK
    • About 900 for England and Wales
    • About 16/million population
  • Does not take into account the impact of possible trials of lower risk patients

ACI 2009