OBJECTIVES: The German healthcare system was among the first markets to introduce transcatheter aortic valve replacement (TAVR) in routine care. Our objective was to estimate the impact of TAVR availability on overall aortic valve replacement volumes and competing therapies in this real-world setting. METHODS: Therapy- and age-specific procedure volumes were collected from German Federal Statistics Office databases for TAVR and surgical aortic valve replacement (SAVR) via sternotomy for years 2009 through 2013. Discharge and hospital-based mortality data were obtained for the same period based on applicable ICD-10 diagnosis. We computed therapy-specific and total procedure volumes and growth stratified by 5-year age increments and in total. Discharge and mortality data for aortic valve disease hospitalizations was assessed to obtain an estimate of changes in per-case mortality. RESULTS: In the time period 2009 to 2013 overall procedure volumes grew from 26,466 to 33,235 (+26%). This growth was driven by TAVR (3,411 to 10,814; +217%), while SAVR volumes remained stable (23,055 to 22,421; -3%). In patients 75 years or older, an overall procedure growth of 51% was observed (12,168 to 18,318), with volumes in older patient segments growing more heavily (+62% in >80-year olds; +101% in >85-year olds). Across all elderly age groups, SAVR volumes decreased (-20% in >80 year olds; -37% in >85 year olds), while they grew in selected younger patients groups (highest growth +30% in age group 60-64 yrs.). Concurrently, total aortic valve disease hospital discharges grew by 26%, from 44,161 to 55,748, while mortality per hospitalization case decreased by 5% between 2009 and 2013. CONCLUSIONS: The availability of TAVR has contributed to substantial growth in aortic valve replacements in Germany, specifically in elderly populations previously left untreated. This growth was associated with a concurrent gradual decline in overall mortality of aortic valve-related hospitalizations.