Transcatheter aortic valve replacement outcomes improved from 2011 to 2019, with 30-day mortality decreasing from 7.2% to 2.5% and stroke decreasing from 2.75% to 2.3%.
Observational (n=276,316)
Yes
What are the real-world trends in procedural characteristics and clinical outcomes for patients undergoing TAVR in the United States?
276,316 patients undergoing transcatheter aortic valve replacement (TAVR) at sites in all U.S. states from 2011 to 2019, ranging from extreme- to low-risk.
Transcatheter aortic valve replacement (TAVR)
Trends in procedural volumes, access routes, hospital stay, discharge status, 30-day mortality, stroke, pacemaker need, and 1-year patient-reported outcomeshard clinical
The STS-ACC TVT Registry demonstrates a massive growth in TAVR volume across all risk categories in the US, accompanied by significant reductions in 30-day mortality and stroke rates from 2011 to 2019.
Absolute Event Rate: 2.5% vs 7.2%
The STS-ACC TVT Registry (Society of Thoracic Surgeons-American College of Cardiology Transcatheter Valve Therapy Registry) from 2011 to 2019 has collected data on 276,316 patients undergoing transcatheter aortic valve replacement (TAVR) at sites in all U.S. states. Volumes have increased every year, exceeding surgical aortic valve replacement in 2019 (72,991 vs. 57,626), and it is now performed in all U.S. states. TAVR now extends from extreme- to low-risk patients. This is the first presentation on 8,395 low-risk patients treated in 2019. In 2019, for the entire cohort, femoral access increased to 95.3%, hospital stay was 2 days, and 90.3% were discharged home. Since 2011, the 30-day mortality rate has decreased (7.2% to 2.5%), stroke has started to decrease (2.75% to 2.3%), but pacemaker need is unchanged (10.9% to 10.8%). Alive with acceptable patient-reported outcomes is achieved in 8 of 10 patients at 1 year. The Registry is a national resource to improve care and analyze TAVR's evolution. Real-world outcomes, site performance, and the impact of coronavirus disease 2019 will be subsequently studied. (STS/ACC Transcatheter Valve Therapy Registry TVT Registry; NCT01737528).
“The TVT Registry will capture and house patient demographics, procedure details, and facility and physician information. This standardized, evidence based data source will offer much insight into clinical practice patterns and patient outcomes. I believe this coordinated effort optimizes patient safety and ensures the appropriate use of TAVR therapy.”
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John D. Carroll
Interventional Cardiology
Michael J. Mack
Chandigarh University
Sreekanth Vemulapalli
Structural Heart Disease
Journal of the American College of Cardiology
Harvard University
University of Michigan
University of Pennsylvania
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Carroll et al. (Sun,) conducted a observational in Transcatheter aortic valve replacement (n=276,316). Transcatheter aortic valve replacement (TAVR) vs. Historical cohort (2011) was evaluated on 30-day mortality. Transcatheter aortic valve replacement outcomes improved from 2011 to 2019, with 30-day mortality decreasing from 7.2% to 2.5% and stroke decreasing from 2.75% to 2.3%.
synapsesocial.com/papers/69ea3889c2ceeb8fbfae7ea8 — DOI: https://doi.org/10.1016/j.jacc.2020.09.595