Transcatheter aortic valve replacement (TAVR) in the U.S. showed decreasing vascular complication rates (from 5.6% to 4.2%) and stable stroke rates (2.2%) between 2012-2013 and 2014.
Observational (n=26,414)
Yes
What are the current practice trends, patient characteristics, and in-hospital outcomes for TAVR in the United States?
The TVT Registry demonstrates that while TAVR patients remain elderly and high-risk, procedural techniques are evolving with decreasing vascular complications and increased use of percutaneous femoral access.
Absolute Event Rate: 4.2% vs 5.6%
BACKGROUND: The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry has been a joint initiative of the STS and the ACC in concert with multiple stakeholders. The TVT Registry has important information regarding patient selection, delivery of care, science, education, and research in the field of structural valvular heart disease. OBJECTIVES: This report provides an overview on current U.S. TVT practice and trends. The emphasis is on demographics, in-hospital procedural characteristics, and outcomes of patients having transcatheter aortic valve replacement (TAVR) performed at 348 U.S. centers. METHODS: The TVT Registry captured 26,414 TAVR procedures as of December 31, 2014. Temporal trends between 2012 and 2013 versus 2014 were compared. RESULTS: Comparison of the 2 time periods reveals that TAVR patients remain elderly (mean age 82 years), with multiple comorbidities, reflected by a high mean STS predicted risk of mortality (STS PROM) for surgical valve replacement (8.34%), were highly symptomatic (New York Heart Association functional class III/IV in 82.5%), frail (slow 5-m walk test in 81.6%), and have poor self-reported health status (median baseline Kansas City Cardiomyopathy Questionnaire score of 39.1). Procedure performance is changing, with an increased use of moderate sedation (from 1.6% to 5.1%) and increase in femoral access using percutaneous techniques (66.8% in 2014). Vascular complication rates are decreasing (from 5.6% to 4.2%), whereas site-reported stroke rates remain stable at 2.2%. CONCLUSIONS: The TVT Registry provides important information on characteristics and outcomes of TAVR in contemporary U.S. clinical practice. It can be used to identify trends in practice and opportunities for quality improvement.
Holmes et al. (Mon,) conducted a observational in Aortic valve disease requiring TAVR (n=26,414). Transcatheter aortic valve replacement (TAVR) in 2014 vs. TAVR in 2012-2013 was evaluated on Vascular complications. Transcatheter aortic valve replacement (TAVR) in the U.S. showed decreasing vascular complication rates (from 5.6% to 4.2%) and stable stroke rates (2.2%) between 2012-2013 and 2014.