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Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012
Journal article   Open access   Peer reviewed

Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012

Edward L Hannan, Zaza Samadashvili, Nicholas J Stamato, Stephen J Lahey, Andrew Wechsler, Desmond Jordan, Thoralf M Sundt, 3rd, Jeffrey P Gold, Carlos E Ruiz, Mohammed H Ashraf, …
JACC. Cardiovascular interventions, v 9(6), pp 578-585
28 Mar 2016
DOI: https://doi.org/10.1016/j.jcin.2015.12.022
PMID: 27013157
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.jcin.2015.12.022View
Published, Version of Record (VoR)Open Access (Publisher-Specific),  Open

Abstract

Aged Aged, 80 and over Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - mortality Aortic Valve Stenosis - therapy Cardiac Catheterization - adverse effects Cardiac Catheterization - mortality Cardiac Catheterization - trends Female Heart Valve Prosthesis Implantation - adverse effects Heart Valve Prosthesis Implantation - mortality Heart Valve Prosthesis Implantation - trends Humans Logistic Models Male Middle Aged New York Practice Patterns, Physicians' - trends Propensity Score Proportional Hazards Models Registries Risk Assessment Risk Factors Severity of Illness Index Time Factors Treatment Outcome
The purpose of this study was to investigate changes in the use of transcatheter aortic valve replacement (TAVR) relative to surgical aortic valve replacement (SAVR) and to examine relative 1-year TAVR and SAVR outcomes in 2011 to 2012 in a population-based setting. TAVR has become a popular option for patients with severe aortic stenosis, particularly for higher-risk patients. New York's Cardiac Surgery Reporting System was used to identify TAVR and SAVR volumes and to propensity match TAVR and SAVR patients using numerous patient risk factors contained in the registry to compare 1-year mortality rates. Mortality rates were also compared for different levels of patient risk. The total number of aortic valve replacement patients increased from 2,291 in 2011 to 2,899 in 2012, an increase of 27%. The volume of SAVR patients increased by 7.1% from 1,994 to 2,135 and the volume of TAVR patients increased 157% from 297 to 764. The percentage of SAVR patients that were at higher risk (≥3% New York State [NYS] score, equivalent to a Society of Thoracic Surgeons score of about 8%) decreased from 27% to 23%, and the percentage of TAVR patients that were at higher risk decreased from 83% to 76%. There was no significant difference in 1-year mortality between TAVR and SAVR patients (15.6% vs. 13.1%; hazard ratio [HR]: 1.30 [95% confidence interval (CI): 0.89 to 1.92]). There were no differences among patients with NYS score <3% (12.5% vs. 10.2%; HR: 1.42 [95% CI: 0.68 to 2.97]) or among patients with NYS score ≥3% (17.1% vs. 14.5%; HR: 1.27 [95% CI: 0.81 to 1.98]). TAVR has assumed a much larger share of all aortic valve replacements for severe aortic stenosis, and the average level of pre-procedural risk has decreased substantially. There are no differences between 1-year mortality rates for TAVR and SAVR patients.

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23 citations in Web of Science
22 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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