Key result
Very-high-volume hospitals (≥200 cases/year) had a significantly lower incidence of surgical bailout after TAVR compared to low-volume hospitals (0.49% vs 1.81%; OR 0.28, 95% CI 0.21-0.38).
Why the study?
Surgical bailout is needed for serious complications during or after TAVR, but whether hospital procedural experience affects its incidence and outcomes remains unclear.
Does higher hospital procedural volume reduce the incidence and in-hospital mortality of surgical bailout in patients undergoing TAVR?
Observational
Yes
Does higher hospital procedural volume reduce the incidence and in-hospital mortality of surgical bailout in patients undergoing TAVR?
Odds Ratio: 0.28 (95% CI 0.21–0.38)
Absolute Event Rate: 0.49% vs 1.81%
Higher hospital TAVR volume is associated with a lower incidence of surgical bailout, but the high in-hospital mortality of surgical bailout remains unchanged regardless of hospital volume.
May warrant TAVR referral to higher-volume centers to potentially reduce bailout risk; leaves open whether volume directly improves outcomes.
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Isogai et al. (2021) conducted an observational in Transcatheter aortic valve replacement (TAVR). Very-high hospital procedural volume (≥200 cases/year) vs. Low hospital procedural volume (≤49 cases/year) was evaluated on Incidence of surgical bailout (SB) (OR 0.28, 95% CI 0.21-0.38). Very-high-volume hospitals (≥200 cases/year) had a significantly lower incidence of surgical bailout after TAVR compared to low-volume hospitals (0.49% vs 1.81%; OR 0.28, 95% CI 0.21-0.38).
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