Annette Brüls, corporate vice president at Edwards Lifesciences EMEA, Canada and Latin America, explains why timely intervention is a win for patients, clinicians and healthcare systems.
Every ten minutes, structural heart disease causes a death in Europe, highlighting the need for urgent action. Aortic stenosis, one of the most common and deadly forms of structural heart disease, is rising in parallel with Europe’s ageing population. Today, more than 14 million Europeans are living with structural heart disease; by 2040, that number will exceed 20 million. Without adopting breakthrough treatment approaches, our hospitals will struggle to keep pace.
In fact, many already do. Severe aortic stenosis patients often wait months for treatment while hospitals face staff shortages and overstretched cardiology units. Clinicians must triage patients, knowing some will certainly deteriorate while waiting. In the UK alone, 400 patients die on waiting lists each year. Emergency admissions rise, causing declines in outcomes and raising costs. Europe stands before a critical question: can we still afford to wait for symptoms before acting?
Innovation that changes the equation
At a conference in London earlier this year, Edwards Lifesciences presented a health economics analysis conducted by the York Health Economics Consortium across nine European countries. The findings are striking: timely transcatheter aortic valve replacement (TAVR or TAVI) in asymptomatic severe aortic stenosis patients delivers lifetime per patient savings of £1,788 in the UK and up to CHF15,802 in Switzerland. Applied to the estimated 100,000 newly asymptomatic severe aortic stenosis patients each year, potential annual savings could exceed €500 million (£437 million) for Europe.
This is not incremental progress; it is a transformation in how aortic stenosis can and should be managed. Timely treatment with TAVR, even before symptoms manifest, proves that better care can cost less, and is not only clinically preferable but economically rational.
Early treatment does not just add years to life, it adds life to years
For decades, the standard approach has been to wait until symptoms appear. But severe aortic stenosis is a progressive, life-threatening condition. When symptoms manifest, irreversible cardiac damage may already have taken hold. Waiting is not caution, it is a risk. No one waits for cancer symptoms before acting. So why should severe aortic stenosis, with outcomes just as devastating, be treated differently?
Data from the early TAVR trial confirms what clinicians witness daily: timely intervention prevents decline. It reduces strokes and heart failure hospitalisations and protects cardiac function. Most importantly, it preserves quality of life. Patients remain active members of their families and communities, not passive recipients waiting for urgent care.
Physicians: from crisis management to evidence-based proactive approach
The shift toward timely treatment is now reinforced by the recently updated ESC/EACTS guidelines, which recommend intervention in asymptomatic severe aortic stenosis patients. This marks a pivotal change: physicians are empowered to act before crises emerge, guided by robust evidence.
With timely diagnosis and treatment, clinicians can move away from reactive crisis management to proactive, patient-centred care. They can anticipate risk, prevent deterioration, and deliver interventions at the moment they are most effective. This is medicine at its best, evidence-based, timely, and transformative.
The guidelines also emphasise patient-centred decision-making in valvular heart disease. Heart Teams now combine clinical expertise with patient values to align interventions with quality-of-life goals. Transparent discussions on risks, durability, and lifestyle make patient preferences a core element of evidence-based care within specialised heart valve centres.
Healthcare systems: Breaking the cycle of strain
Healthcare leaders frequently face challenging decisions that require balancing compassionate care with effective cost management. Early TAVR challenges that premise. The lifetime savings demonstrated by the study are not abstract; they translate directly into fewer strokes, fewer complications, and fewer hospitalisations.
In an era of workforce shortages and rising demand, this level of efficiency is not a luxury; it is a necessity. Early intervention breaks the cycle of strain, freeing resources, allowing better planning, and supporting sustainability for healthcare systems under pressure.
Europe’s next step
Cardiovascular disease remains the number one killer in Europe, placing immense strain on patients, clinicians, and health systems. The evidence now shows that timely intervention in aortic stenosis can ease this burden, improving outcomes, supporting physicians, and strengthening healthcare sustainability.
As European institutions prepare the upcoming European Cardiovascular Health Plan to tackle the burden of cardiovascular disease, timely treatment should be embedded as a priority. Early TAVR demonstrates how innovation can deliver lasting value: better outcomes for patients, more proactive pathways for clinicians, and greater resilience for healthcare systems. Science supports it. Economics reinforce it. And Europe’s future cardiovascular strategy should make it happen.
