TAVR stands tall as ‘the dominant form of aortic valve replacement,’ specialty groups declare

 

In November 2011, the first device for transcatheter aortic valve replacement (TAVR) gained FDA approval. Now, just nine years later, industry leaders are recognizing TAVR as a valuable, consistent treatment for severe aortic stenosis and a handful of other indications.

“TAVR is the dominant form of aortic valve replacement, with sites in all 50 states,” representatives from the American College of Cardiology (ACC) and Society of Thoracic Surgeons (STS) wrote in a new state-of-the-art review. “Outcomes out to one year have steadily improved. Further growth is expected with recovery of the healthcare system in the new world of COVID-19.”

The analysis, published in both the Journal of the American College of Cardiology and Annals of Thoracic Surgery, is the work of the STS–ACC Transcatheter Valve Therapy (TVT) Registry. It includes data from all active TAVR sites in the United States from 2011 to 2019, which covers more than 276,000 patients.

The report’s authors emphasized that TAVR volumes have continued to increase in the United States since its introduction. In 2019, for instance, more than 72,000 TAVR procedures occurred in the country—more than 15,000 more than the number of surgical aortic valve replacement procedures. TAVR is also now recommended for both low-risk patients and high-risk patients.

Some other key points from the evaluation:

  • Since 2011, 30-day mortality and stroke have become less likely after a TAVR procedure.
  • The median age of TAVR patients is now 80 years old. The median age used to be 84 years old.
  • Most patients undergo TAVR for severe aortic stenosis, but a failed bioprosthetic valve and mixed aortic stenosis/aortic regurgitation are also standard indications for this procedure.

“The STS/ACC TVT Registry allows us to see major trends occurring in the real-world TAVR patient population, including a rapid growth in both the number of hospital sites performing TAVR and case volume as we treat a broader spectrum of patients,” first author John D. Carroll, MD, chair of the STS-ACC TVT Registry Steering Committee, said in a prepared statement from the ACC. “We have also seen TAVR become the leading choice for aortic valve replacement compared to the open surgical approach. Furthermore, the data on outcomes after TAVR document a substantial improvement in quality of care in the last nine years.”

The full state-of-the-art review can be read here and here.