title: Annual Outcomes With Transcatheter Valve Therapy: From the STS/ACC TVT Registry.
abstract: BACKGROUND
  The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry has been a joint initiative of the STS and the ACC in concert with multiple stakeholders. The TVT Registry has important information regarding patient selection, delivery of care, science, education, and research in the field of structural valvular heart disease.
  
  
  OBJECTIVE
  This report provides an overview on current U.S. TVT practice and trends. The emphasis is on demographics, in-hospital procedural characteristics, and outcomes of patients having transcatheter aortic valve replacement (TAVR) performed at 348 U.S. centers.
  
  
  METHODS
  The TVT Registry captured 26,414 TAVR procedures as of December 31, 2014. Temporal trends between 2012 and 2013 versus 2014 were compared.
  
  
  RESULTS
  Comparison of the 2 time periods reveals that TAVR patients remain elderly (mean age 82 years), with multiple comorbidities, reflected by a high mean STS predicted risk of mortality (STS PROM) for surgical valve replacement (8.34%), were highly symptomatic (New York Heart Association functional class III/IV in 82.5%), frail (slow 5-m walk test in 81.6%), and have poor self-reported health status (median baseline Kansas City Cardiomyopathy Questionnaire score of 39.1). Procedure performance is changing, with an increased use of moderate sedation (from 1.6% to 5.1%) and increase in femoral access using percutaneous techniques (66.8% in 2014). Vascular complication rates are decreasing (from 5.6% to 4.2%), whereas site-reported stroke rates remain stable at 2.2%.
  
  
  CONCLUSIONS
  The TVT Registry provides important information on characteristics and outcomes of TAVR in contemporary U.S. clinical practice. It can be used to identify trends in practice and opportunities for quality improvement.
authors.affiliation: Mayo Clinic, Rochester, Minnesota. Electronic address: holmes.david@mayo.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Rick A
authors.initials: RA
authors.lastname: Nishimura
authors.affiliation: University of Colorado, Denver, Colorado.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Grover
authors.affiliation: University of California, San Francisco, California.
authors.forename: Ralph G
authors.initials: RG
authors.lastname: Brindis
authors.affiliation: University of Colorado, Denver, Colorado.
authors.forename: John D
authors.initials: JD
authors.lastname: Carroll
authors.affiliation: University of Florida, Jacksonville, Florida.
authors.forename: Fred H
authors.initials: FH
authors.lastname: Edwards
authors.affiliation: Duke University Medical Center, Durham, North Carolina.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.affiliation: Denver VA Medical Center, Denver, Colorado.
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: David M
authors.initials: DM
authors.lastname: Shahian
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Vinod H
authors.initials: VH
authors.lastname: Thourani
authors.affiliation: Cleveland Clinic, Cleveland, Ohio.
authors.forename: E Murat
authors.initials: EM
authors.lastname: Tuzcu
authors.affiliation: Duke University Medical Center, Durham, North Carolina.
authors.forename: Sreekanth
authors.initials: S
authors.lastname: Vemulapalli
authors.affiliation: American College of Cardiology, Washington, DC.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hewitt
authors.affiliation: American College of Cardiology, Washington, DC.
authors.forename: Joan
authors.initials: J
authors.lastname: Michaels
authors.affiliation: American College of Cardiology, Washington, DC.
authors.forename: Susan
authors.initials: S
authors.lastname: Fitzgerald
authors.affiliation: Baylor Scott and White Health, Plano, Texas.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mack
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D018579:Patient Selection; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: VARC; aortic stenosis; aortic valve replacement; transcatheter aortic valve replacement; valvular heart disease