2016 Annual Report of The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.
Publication/Presentation Date
3-1-2017
Abstract
BACKGROUND: The Society of Thoracic Surgeons (STS)/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry captures all procedures with Food and Drug Administration-approved transcatheter valve devices performed in the United States, and is mandated as a condition of reimbursement by the Centers for Medicaid & Medicare Services.
OBJECTIVES: This annual report focuses on patient characteristics, trends, and outcomes of transcatheter aortic and mitral valve catheter-based valve procedures in the United States.
METHODS: We reviewed data for all patients receiving commercially approved devices from 2012 through December 31, 2015, that are entered in the TVT Registry.
RESULTS: The 54,782 patients with transcatheter aortic valve replacement demonstrated decreases in expected risk of 30-day operative mortality (STS Predicted Risk of Mortality [PROM]) of 7% to 6% and transcatheter aortic valve replacement PROM (TVT PROM) of 4% to 3% (both p < 0.0001) from 2012 to 2015. Observed in-hospital mortality decreased from 5.7% to 2.9%, and 1-year mortality decreased from 25.8% to 21.6%. However, 30-day post-procedure pacemaker insertion increased from 8.8% in 2013 to 12.0% in 2015. The 2,556 patients who underwent transcatheter mitral leaflet clip in 2015 were similar to patients from 2013 to 2014, with hospital mortality of 2% and with mitral regurgitation reduced to grade ≤2 in 87% of patients (p < 0.0001). The 349 patients who underwent mitral valve-in-valve and mitral valve-in-ring procedures were high risk, with an STS PROM for mitral valve replacement of 11%. The observed hospital mortality was 7.2%, and 30-day post-procedure mortality was 8.5%.
CONCLUSIONS: The TVT Registry is an innovative registry that that monitors quality, patient safety and trends for these rapidly evolving new technologies.
Volume
103
Issue
3
First Page
1021
Last Page
1035
ISSN
1552-6259
Published In/Presented At
Grover, F. L., Vemulapalli, S., Carroll, J. D., Edwards, F. H., Mack, M. J., Thourani, V. H., Brindis, R. G., Shahian, D. M., Ruiz, C. E., Jacobs, J. P., Hanzel, G., Bavaria, J. E., Tuzcu, E. M., Peterson, E. D., Fitzgerald, S., Kourtis, M., Michaels, J., Christensen, B., Seward, W. F., Hewitt, K., … STS/ACC TVT Registry (2017). 2016 Annual Report of The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. The Annals of thoracic surgery, 103(3), 1021–1035. https://doi.org/10.1016/j.athoracsur.2016.12.001
Disciplines
Medicine and Health Sciences
PubMedID
27955994
Department(s)
Department of Surgery
Document Type
Article