EW- Quick Take - NCD Memo +ve (as expected) w/Asymptomatic AS and Lowered Operator Requirements; Shld Add to TAVR Grth Momentum

Research evidence excerpt

EW- Quick Take - NCD Memo +ve (as expected) w/Asymptomatic AS and Lowered Operator Requirements; Shld Add to TAVR Grth Momentum

in a follow up study

rather than being open to all patients, it might create a slower ramp for asymptomatic

Reasons for this report volumes if the NCD is finalized as written. That said, given the STS/ACC TVT registry

(in symptomatic) we think institutions are familiar with CED processes and programs, so

✓ Quick Reaction to Newsflow/Volatility that workflow is familiar a CED in itself shouldn't represent a major barrier. We’ve yet to

see material acceleration in asymptomatic adoption, but we believe it could pick up and

sustain a temporarily elevated TAVR profile in ’27 and beyond if the NCD is finalized as

written.

• Easing the heart-team and site rules. Hospital TAVR programs must still include at

least 1 cardiac surgeon and 1 interventional cardiologist, but they no longer both have

to be present in a given TAVR procedure. The 2019 NCD required the surgeon and

interventionalist to jointly perform the case vs the current proposal allowing for just a single

TAVR operator (IC or surgeon) to do a procedure. The in-person pre-procedure eval can

likewise be done by any heart-team operator, IC or surgeon, vs. a surgeon being required

prior. On operator experience, the proposal simplifies an existing requirement rather than

adding one: the current NCD sets separate criteria by role (surgical valve-replacement

volumes for the surgeon, structural-heart procedures for the IC), whereas the proposal

applies a single per-operator floor counting transcatheter heart-valve procedures (≥20/yr,

≥15 TAVR; or ≥40/2yrs, ≥30 TAVR) to whichever physician who performs the case.

• A 30-day comment period is underway; we expect a Final NCD in 4Q26.