TY - JOUR
T1 - Annual Outcomes with Transcatheter Valve Therapy from the STS/ACC TVT Registry
AU - Holmes, David R.
AU - Nishimura, Rick A.
AU - Grover, Frederick L.
AU - Brindis, Ralph G.
AU - Carroll, John D.
AU - Edwards, Fred H.
AU - Peterson, Eric D.
AU - Rumsfeld, John S.
AU - Shahian, David M.
AU - Thourani, Vinod H.
AU - Tuzcu, E. Murat
AU - Vemulapalli, Sreekanth
AU - Hewitt, Kathleen
AU - Michaels, Joan
AU - Fitzgerald, Susan
AU - Mack, Michael J.
N1 - Publisher Copyright:
© 2015 American College of Cardiology Foundation and The Society of Thoracic Surgeons.
PY - 2015/12/29
Y1 - 2015/12/29
N2 - 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.
AB - 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.
KW - VARC
KW - aortic stenosis
KW - aortic valve replacement
KW - transcatheter aortic valve replacement
KW - valvular heart disease
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U2 - 10.1016/j.jacc.2015.10.021
DO - 10.1016/j.jacc.2015.10.021
M3 - Article
C2 - 26652232
AN - SCOPUS:84955747700
SN - 0735-1097
VL - 66
SP - 2813
EP - 2823
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 25
ER -