An analysis of data from the STS/ACC TVT Registry emphasizes the importance of device iterations and non-device procedural factors when it comes to improving short-term mortality and complications associated with TAVR.

The insights, which were presented by Suzanne V. Arnold, MD, MHA, as part of a late-breaking clinical science session Sept. 18 during TCT 2022, analyzed data from 161,196 patients in the STS/ACC TVT Registry who underwent TAVR at 596 U.S. hospitals between 2011 and 2019. Specifically, researchers assessed the impacts of factors like changes in patient comorbidities, institutional and procedural improvements, and the evolution of devices, on patient outcomes.

According to Arnold, changes in all of these factors have played a role in reducing 30-day death (6.7% to 2.4%), one-year mortality (19.9% to 10.1%) and the 30-day composite of major adverse events (25.3% to 10.5%) since 2011. Broken down by cluster, she notes that in changes in devices and procedural care have had the greatest impact across the board, however changes in patient comorbidities have also had an impact on reductions in long-term mortality. Additionally, changes in institutional learning curves have played larger roles in reductions in 30-day composite adverse events and one-year mortality. Also of note, Arnold said, "there remained a strong association of changes in device and procedural factors with changes in long-term mortality, likely driven by their association with short-term complications."

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 Cardiovascular Therapeutics, TCT22, Aortic Valve, Aortic Valve Stenosis, Transcatheter Aortic Valve Replacement, National Cardiovascular Data Registries, STS/ACC TVT Registry

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