ABSTRACTS S158 Heart, Lung and Circulation CSANZ 2013 Abstracts 2013;22:S126–S266 374 Transcatheter Aortic Valve Replacement in High Risk Patients with Severe Aortic Stenosis: Comparing Costs and Outcomes with Surgery J. Rankin 1,* , G. Yong 1 , E. Geelhoed 2 , C. Gardner 2 , F. Sanfilippo 2 1 Cardiology Department, Royal Perth Hospital, Australia 2 School of Population Health, University of Western Australia, Australia Objective: Transcatheter aortic valve implantation (TAVI) is non-inferior to surgical aortic valve replacement (SAVR) in high-risk patients. TAVI prostheses are signif- icantly more expensive than surgical aortic valves. Cost effectiveness in the Australian context remains unclear. We compared outcomes and costs of TAVI and SAVR in high-risk patients with severe aortic stenosis in Western Australia. Methods: All Western Australian patients with severe aortic stenosis and age ≥80 years or logistic Euroscore ≥20% treated with TAVI or SAVR between the 2008–2011 financial years were included. SAVR patients were iden- tified by linking the cardiothoracic surgery, perfusion and echocardiography databases of the three adult acute ter- tiary hospitals with Hospital Morbidity Data from the WA Data Linkage System. Individual patient cost data were supplied by the Business Units of each hospital. Results: Sixty-five TAVI cases (mean age 84 years, mean logistic Euroscore 22.3%, mean LOS 8.4 days) and 37 SAVR cases (82, 12.7% and 20.1, respectively) were identified. Thirty-day and 12-month mortality was 6.2% and 12.3% for TAVI and 0% and 10.8% for SAVR, (p = 0.79, 12-month). Lengths of hospitalisation were significantly shorter with TAVI (mean 8.2 days vs 20.1 days, p < 0.0001). The mean total cost of the index admission for TAVI was $15,000 less than for SAVR, and $16,000 less at 30 days (including readmissions). Conclusion: These preliminary data from the WA TAVI program suggest that in patients with severe aortic steno- sis at high operative risk, TAVI provides shorter lengths of stay, similar 30-day and 12-month outcomes and is not more costly. http://dx.doi.org/10.1016/j.hlc.2013.05.376 375 Transcatheter Aortic Valve Replacement: A Cost- Effectiveness Analysis for Australia C. Mervin * , P. Scuffham Griffith University, Australia Objective: The purpose of this study was to estimate the additional costs and benefits of transcatheter aortic valve replacement interventions (TAVI) compared to med- ical management (MM; non-surgical intervention) and to surgical management (surgical aortic valve replacement SAVR), delivered to patients with severe aortic valve steno- sis. Methods: A Markov model was designed to compare TAVI to medical management and TAVI to SAVR. The model considers two types of patient populations: high surgical risk patients (who receive TAVI or SAVR) and inoperable patients (who receive TAVI or MM). The model consisted of five health states related to post-procedure events: no complications, heart failure, post-stroke, other complications and death. The model also employs the fol- lowing temporary transition states for acute events: heart failure, stroke, mild paravalvular aortic regurgitation, and moderate/severe paravalvular aortic regurgitation. A 10- year time horizon was selected for the evaluation for patients with a mean age of 80 years. A one-month cycle was used which allows for the use of time-specific tran- sition probabilities. The model is calculated as a cohort expected value analysis, with results reported for a hypo- thetical cohort of 1000 average patients. Results: Final results will be available for presentation at the conference. The analyses include direct health care costs from the perspective of the health care payer. The economic evaluation will illustrate the estimated costs and consequences of treating patients with severe aortic steno- sis with (1) TAVI, (2) SAVR, or (3) medical management. Both cost-effectiveness and cost-utility analyses will be presented. http://dx.doi.org/10.1016/j.hlc.2013.05.377 376 This abstract has been withdrawn 377 Transcathether Aortic Valve Maintains Excellent Hemo- dynamics Based on Echocardiographic Parameters at One Year: A Single Centre Study R. Prakash * , B. Pathik, A. Singh, J. Judd, D. Balakrishnan, R. Perry, L. Brown, A. Swan, S. Lehman, W. Cheng, M. Joseph, D. Chew, J. Bennetts, A. Sinhal Flinders Medical Centre, Australia Background: Two-Year PARTNER trial outcomes have demonstrated durability of the early haemodynamic improvement seen with SAPIEN heart valve. Objective: To assess of our institution specific data in regards to valve performance and LV parameters within a year of implantation. Methods: The Flinders Medical Centre echocardiog- raphy database was interrogated for observed SAPIEN valve parameters, post procedure and at one year follow up. Data included valve haemodynamics and degree of paravalvular leak. Left ventricular parameters included ejection fraction (biplane EF), left ventricular end diastolic dimension (LVEDD) and interventricular septal dimen- sion (IVSD). Data were compared using the Student’s t-test.