Many patients undergoing transcatheter aortic valve repair (TAVR) in the United States may be receiving below-average care, according to a new study published ahead of print in Circulation.

The study’s authors developed and validated a new performance measure for TAVR care using data from more than 52,000 patients. All patients were treated from 2015 to 2017. Data came from the STS/ACC TVT Registry, a collaboration of the Society of Thoracic Surgeons, American College of Cardiology, FDA and CMS.  

“The broad goals of this performance measure were to serve as a national benchmark for quality-of-care monitoring and to support both local quality improvement efforts as well as national efforts to use quality rather than volume requirements to maintain TAVR programs,” wrote lead author Nimesh D. Desai, MD, PhD, a specialist in the division of cardiovascular surgery at Hospital of the University of Pennsylvania, and colleagues.

Taking a close look at both mortality rates and patient outcomes, the group determined that stroke, major bleeding events, acute kidney injury and moderate or severe peri-valvular regurgitation were the most effective complications to use when developing their performance measure. Based on their analysis, Desai et al. found that there was “significant site-level variation in quality of care in TAVR in the United States.”