OBJECTIVES: To provide real-world estimates of costs of heart valve implantations, complications and other healthcare during three post-intervention years. METHODS: We performed retrospective analyses of healthcare costs of patients that underwent heart valve implantations in 2010-2013 using claims data from health insurers (covering 99% of the Dutch citizens). Patients were selected using Diagnosis Related Group-codes and were followed from time of intervention until 31-12-2013. Costs of heart valve implantations, complications, and other types of healthcare (general practitioners, pharmaceuticals, home care, nursing homes, etcetera) were determined. To calculate the excess healthcare costs due to the heart valve implantation, we compared total healthcare costs of patients with total healthcare costs of a random sample of the Dutch population stratified by age, gender, socio-economic status, and co-morbidities. To address uncertainty, we applied non-parametric bootstrapping (2000 replicates). RESULTS:  The 18,903 patients (17,991 underwent surgical valve replacement (SVR) and 912 transcatheter valve implantation (TVI)) and the 188,925 controls had comparable baseline characteristics. The mean procedure costs (excluding complications) were €18,000 (95% confidence interval(CI):17,936-18,063) for SVR and €27,841(CI:27,643-28,042) for TVI. The total healthcare costs of patients (SVR) were significantly higher than in the control sample, particularly in the year of implantation (difference year 1=€34,954(CI:34,528-35,381); year 2=€1,641(CI:1,332-1,980); year 3=€2,301(CI:1,821-2,785)). Costs were significantly higher for patients compared to controls in most types of healthcare, but costs were significantly lower for nursing homes (year 1-3). CONCLUSIONS: After a heart valve implantation, patients have significantly higher healthcare costs compared to those in the control sample, particularly in the year of implantation. In the following years, survival of the fittest patients and lower complications rates may explain the decrease in higher costs of patients. The significantly lower costs of patients for nursing homes may be due to selection of relatively healthy elderly to undergo open-heart surgery.