Key result
TAVR at lower-volume institutions shows 1-year mortality comparable to the PARTNER III trial.
Why the study?
The study was conducted to analyze TAVR procedural volume and outcomes at a lower-volume institution and compare them with the PARTNER III trial.
Does TAVR performed at a lower-volume institution yield comparable clinical outcomes to those reported in major trials like PARTNER III?
Observational (n=37)
No
Does TAVR performed at a lower-volume institution yield comparable clinical outcomes to those reported in major trials like PARTNER III?
Absolute Event Rate: 2.7% vs 8.5%
p-value: p=0.3
TAVR performed at a lower-volume institution demonstrated excellent 30-day and 1-year outcomes comparable to those seen in major clinical trials, challenging the assumption that superior outcomes require high institutional volume.
Institutional TAVR outcomes match PARTNER III; leaves open generalizability and need for prospective validation before practice change.
Objectives: TAVR is a minimally invasive alternative to SAVR, offering a key treatment for high-risk patients with severe aortic stenosis, including those with advanced age or comorbidities. Its popularity has led to its use in lower volume institutions, where outcomes are comparable to higher volume centers. This study analyzes procedural volume and outcomes at our institution, compares them with the PARTNER III trial, and evaluates complications and patient selection criteria. Design: This was a retrospective descriptive study. Setting: This study was performed at a public, multi-institutional healthcare system featuring an acute care hospital with a Level I Adult Trauma and Burn Center. Participants: We obtained retrospective data on 37 patients who underwent TAVR in our hospital system in 2022. Data was collected on their outcomes, including mortality, readmission rates, and cardiovascular and cerebrovascular complications at 30 days and 1 year. Interventions: No interventions were performed on patients as this was a retrospective study. Measurements and Main Results: Patient outcomes were compared with PARTNER III trial results. There was no 30-day mortality (versus 1% in the PARTNER III trial), and a 1-year mortality rate of 2.7% as compared to 8.5% in the PARTNER III trial. At 30 days, 0% of patients were readmitted for valve-related issues. Conclusions: This study demonstrates that lower volume healthcare institutions can achieve outcomes comparable/similar to higher volume institutions in specialized procedures like TAVR, challenging the assumption that superior outcomes are tied to institutional size. Our findings highlight the importance of quality, teamwork, and individualized care in achieving excellent clinical outcomes, regardless of size.
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Nisar et al. (2025) conducted an observational in Severe aortic stenosis (n=37). Transcatheter Aortic Valve Replacement (TAVR) at a lower-volume institution vs. PARTNER III trial cohort (higher-volume institutions) was evaluated on 1-year mortality (p=0.3). TAVR performed at a lower-volume institution resulted in a 1-year mortality rate of 2.7%, which was comparable to the 8.5% mortality rate observed in the PARTNER III trial (p=0.3).
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