Bio

Clinical Focus


  • Internal Medicine

Academic Appointments


Professional Education


  • Fellowship:VA Medical Center Palo Alto (2009) CA
  • Residency:Stanford University Hospital -Internal Medicine Residency Training Program (2008) CA
  • Medical Education:New York University - School Of Medicine (2005) NY
  • Board Certification: Internal Medicine, American Board of Internal Medicine (2008)

Publications

Journal Articles


  • Transcatheter Aortic Valve Replacement in Nonsurgical Candidates With Severe, Symptomatic Aortic Stenosis: A Cost-Effectiveness Analysis CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES Simons, C. T., Cipriano, L. E., Shah, R. U., Garber, A. M., Owens, D. K., Hlatky, M. A. 2013; 6 (4): 419-428

    Abstract

    Background- Transcatheter aortic valve replacement (TAVR) seems to improve the survival and quality of life of patients with aortic stenosis ineligible for surgical aortic valve replacement. Methods and Results- We used a decision analytic Markov model to estimate lifetime costs and benefits in a hypothetical cohort of patients with severe, symptomatic aortic stenosis who were ineligible for surgical aortic valve replacement. The model compared transfemoral TAVR with medical management and was calibrated to the Placement of Aortic Transcatheter Valves (PARTNER) trial. TAVR increased life expectancy from 2.08 to 2.93 years and quality-adjusted life expectancy from 1.19 to 1.93 years. TAVR also reduced subsequent hospitalizations by 1.40 but increased complications, particularly stroke (from 1% to 11% lifetime risk), and also increased lifetime costs from $83 600 to $1 69 100. The incremental cost-effectiveness of TAVR was $1 16 500 per quality-adjusted life-year gained ($99 900 per life-year gained). Results were robust to reasonable changes in individual variables but were sensitive to the level of annual healthcare costs caused by noncardiac diseases and to the projected life expectancy of medically treated patients. Conclusions- TAVR seems to be an effective but somewhat expensive alternative to medical management among patients with symptomatic aortic stenosis ineligible for surgery. TAVR is more cost-effective for patients with a lower burden of noncardiac disease.

    View details for DOI 10.1161/CIRCOUTCOMES.113.000280

    View details for Web of Science ID 000321898000009

    View details for PubMedID 23838104

  • Cost-Effectiveness of Transcatheter Aortic Valve Replacement CIRCULATION Hlatky, M. A., Simons, C. T. 2012; 125 (9): 1076-1077

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