Comparative environmental life cycle assessment between transfemoral transcatheter aortic valve implantation and isolated surgical aortic valve replacement.
prospective_cohort · Level II
Where this comes from
- Record sourced from PubMed, PMID 42527114.
- Also identified by DOI 10.1136/heartjnl-2026-328011.
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Abstract
Comparisons between transfemoral transcatheter aortic valve implantation (TF-TAVI) and surgical aortic valve replacement (SAVR) in severe aortic stenosis have demonstrated a consistent mortality benefit, lower 1 year costs and greater quality-adjusted life years in favour of TF-TAVI. However, the differences in the environmental impact of these two interventions have not yet been sufficiently investigated. The aim of the present study was to compare the intraprocedural environmental impact of these two procedures and to identify emission hotspots in order to mitigate their environmental impact. In this prospective, observational, single-centre study, usage data were collected from 15 TF-TAVI and 15 SAVR procedures. All products, energy and water consumed during the procedures were identified and were used in a comprehensive comparative environmental life cycle assessment to quantify the intraprocedural environmental impact of these two interventions. Material use in SAVR amounted to 17.7 kg compared with 8.7 kg in TF-TAVI, consisting of 84% and 69% plastics, respectively. Electricity use in TF-TAVI was 52% less than in SAVR; in both interventions, energy consumption was dominated by the use of electronic devices. In SAVR, water consumption was 30 times higher than in TF-TAVI (5800 vs 194 L), mainly due to the heating cooling system of the cardiopulmonary bypass in SAVR. In all 10 calculated environmental impact categories, SAVR had a greater life-cycle impact. Its carbon footprint was 181.2 kg CO<sub>2</sub>-eq, compared with 68.6 kg CO<sub>2</sub>-eq per TF-TAVI. TF-TAVI outperformed SAVR in all environmental impact categories and had a carbon footprint of 38% that of SAVR. In TF-TAVI, 51% less material, 52% less energy and 97% less water were used. Despite these impressive results, there is still room for improvement in the environmental impact of TF-TAVI by using fewer disposable items, powering down idle imaging systems and introducing reusable/remanufactured valve delivery systems.