Fix the heart valve before symptoms start: early treatment adds healthy life at a bargain price

Aortic stenosis means the heart's main exit valve has narrowed, forcing the heart to push harder with every beat. Many people feel fine for years, so doctors often simply watch and wait. A gentler fix exists: TAVR, where a new valve is threaded into place through a thin tube, with no open-heart surgery. Now a new cost analysis of the EARLY TAVR trial, presented at the TCT 2026 conference, asks what happens if doctors act before symptoms begin. The upfront bill is higher, but nearly everyone who waited went on to need the valve anyway — so after five years the total costs were almost identical: $86,572 for early treatment versus $85,044 for watchful waiting. Over a lifetime, acting early added about $4,500 in cost and 0.3 extra years of life in good health — about $14,698 per healthy year gained, far below the $120,000 figure doctors commonly call good value. One expert on the panel said the true benefit is probably larger still, because trial patients who waited were watched unusually closely and treated the moment symptoms appeared, while real-world patients often wait longer and get sicker first.

SDG 3 · Good health and well-being — Mechanism: tech innovation