Transcatheter aortic valve replacement (TAVR) may be appropriate in patients with aortic regurgitation (AR) who are not candidates for surgical aortic valve replacement, according to a study published recently in the American Journal of Cardiology.

Using data from the STS/ACC TVT Registry, Saif Anwaruddin, MD, et al., evaluated outcomes in 230 patients who underwent TAVR for native AR using a commercially available self-expanding valve system. The study's primary outcome was 30-day all-cause mortality, while secondary outcomes included in-hospital clinical outcomes, postprocedure AR rates, device success and one-year all-cause mortality.

According to the results, the 30-day all-cause mortality rate was 13.3 percent. In-hospital all-cause mortality occurred in 12.2 percent of patients, and the median length of stay in the hospital was 5.5 days. After TAVR, about 10 percent of patients had moderate to severe AR. Overall, device success was reported in 81.7 percent of patients. The success rate improved among patients who underwent TAVR with newer vs. older generation devices. The one-year all-cause mortality rate was 22.8 percent.

The study's findings suggest that, despite high 30-day all-cause mortality, self-expanding TAVR may be effective in reducing AR and improving quality of life in patients who are not suitable candidates for surgery, the authors note. They conclude that improved outcomes in patients who received newer generation devices "highlight the need for advancements in device technology and careful patient selection."

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Valvular Heart Disease, Aortic Surgery, Cardiac Surgery and VHD, Interventions and Structural Heart Disease

Keywords: Transcatheter Aortic Valve Replacement, Aortic Valve Insufficiency, Aortic Valve, Patient Selection, Quality of Life, Length of Stay, Heart Valve Prosthesis, Hospital Mortality, Outcome Assessment, Health Care, Registries, National Cardiovascular Data Registries, STS/ACC TVT Registry

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