Aortic valve stenosis is a common heart disease that occurs when the aortic valve in the heart has narrowed, causing the heart to work harder to pump blood to the body.

The usual treatment is to replace the damaged valve with an artificial one through open-heart surgery; this is known as surgical aortic valve replacement. Another option, called transcatheter aortic valve implantation, is a less invasive procedure that may benefit people who are too frail for open-heart surgery. This procedure involves going through an artery, most commonly in the leg, to place an artificial valve inside the damaged one.

Ontario Health looked at how safe and effective transcatheter aortic valve implantation is for people with severe aortic valve stenosis who are at intermediate risk for surgery (which means at increased risk of dying within 30 days of a surgical valve replacement). We also looked at the cost-effectiveness and budget impact of publicly funding this procedure for people at this risk level, and we talked with people with aortic valve stenosis to learn about their experiences, preferences and values.