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Outcomes Following Transcatheter Aortic Valve Replacement in the United States
This important article describes the initial US commercial experience of transcatheter aortic valve replacement (TAVR) since this therapy was approved by the FDA in 2011. It reports the results of 7710 eligible patients that underwent TAVR for high-risk or inoperable status in 250 centers and were included in the STS/ACC TVT Registry. The median age of the patients was 84 years; 20% were defined as inoperable for standard aortic valve replacement and 80% were considered high operative risk. Of all procedures, 64% were transfemoral, 29% transapical, and the rest performed using other approches. The device was successfully implanted in 92% of cases. In-hospital mortality was 5.5% with risk of stroke being 2%. Conversion to open heart surgery (1%) was associated with very high in-hospital mortality (49%). The authors conclude that US outcomes in the commercial TAVR era are similar to the previously published outcomes from the PARTNER trial and from European trials. Long-term follow-up is needed.