Clinical outcomes at 1 year following transcatheter aortic valve replacement

JAMA : the Journal of the American Medical Association
David R HolmesSTS/ACC TVT Registry

Abstract

Introducing new medical devices into routine practice raises concerns because patients and outcomes may differ from those in randomized trials. To update the previous report of 30-day outcomes and present 1-year outcomes following transcatheter aortic valve replacement (TAVR) in the United States. Data from the Society of Thoracic Surgeons/American College of Cardiology (STS/ACC) Transcatheter Valve Therapies Registry were linked with patient-specific Centers for Medicare & Medicaid Services (CMS) administrative claims data. At 299 US hospitals, 12 182 patients linked with CMS data underwent TAVR procedures performed from November 2011 through June 30, 2013, and the end of the follow-up period was June 30, 2014. Transcatheter aortic valve replacement. One-year outcomes including mortality, stroke, and rehospitalization were evaluated using multivariate modeling. The median age of patients was 84 years and 52% were women, with a median STS Predicted Risk of Operative Mortality (STS PROM) score of 7.1%. Following the TAVR procedure, 59.8% were discharged to home and the 30-day mortality was 7.0% (95% CI, 6.5%-7.4%) (n = 847 deaths). In the first year after TAVR, patients were alive and out of the hospital for a median of 353 days...Continue Reading

Citations

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