{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T00:43:57Z","timestamp":1794271437659,"version":"4.9.0"},"reference-count":14,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec id=\"ab-hoi240060-4\"><jats:title>Importance<\/jats:title><jats:p>Although transcatheter aortic valve replacement (TAVR) outcomes in the US have improved substantially since 2011, it is unknown whether these trends have continued since 2019.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi240060-5\"><jats:title>Objective<\/jats:title><jats:p>To examine changes in risk-adjusted TAVR outcomes from 2019 to 2022 and to examine any noteworthy trends over time.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi240060-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study examined data from patients with severe aortic stenosis treated with TAVR at 786 US hospitals between January 1, 2019, and March 31, 2022, included in the Society of Thoracic Surgeons (STS)\/American College of Cardiology (ACC) Transcatheter Valve Therapies (TVT) Registry.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi240060-7\"><jats:title>Exposure<\/jats:title><jats:p>Patients who underwent TAVR.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi240060-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was 30-day mortality, and the secondary outcomes were in-hospital mortality and 30-day composite adverse events. To understand factors explaining these trends, a series of logistic regression models was constructed for each outcome, with time as the primary explanatory variable. After adjusting for changing patent characteristics and procedural factors, a series of exploratory analyses was performed to examine the extent to which these findings could be explained by several plausible hypotheses.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi240060-9\"><jats:title>Results<\/jats:title><jats:p>This study\u2019s analytic cohort included a total of 210\u202f495 patients. Median (IQR) patient age was 79 (73-85) years, and 91\u202f313 patients (43.4%) were female. Median (IQR) STS predicted risk of mortality (PROM) was 3.3% (2.0%-5.3%). There were no significant changes in unadjusted 30-day mortality from quarter 1 of 2019 (2.4%) to the end of quarter 1 of 2022 (2.2%) (<jats:italic>P<\/jats:italic> for trend\u2009=\u2009.10), with an unadjusted odds ratio (OR) for time of 0.98 per year (95% CI, 0.94-1.01). After adjusting for patient characteristics, the OR increased to 1.05 per year (95% CI, 1.02-1.08), which increased further after adjusting for procedural characteristics to 1.09 per year (95% CI, 1.05-1.13). In exploratory analyses, there were no meaningful changes in the adjusted odds of death after excluding sites that entered the STS\/ACC TVT Registry in 2019 or later (OR, 1.09; 95% CI, 1.05-1.13), low-volume sites (OR, 1.09; 95% CI, 1.06-1.13), low-risk patients (OR, 1.11; 95% CI, 1.07-1.15), patients with a bicuspid aortic valve (OR, 1.09; 95% CI, 1.05-1.13), in-hospital deaths (OR, 1.08; 95% CI, 1.03-1.14), or patients who experienced a major vascular complication (OR, 1.09; 95% CI, 1.05-1.12).<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi240060-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this observational cohort study performing a national analysis of outcomes after TAVR, it was found that risk-adjusted 30-day mortality increased modestly from January 2019 to March 2022. However, no site-level, patient-related, or process-related factors were identified that could explain these findings. Although the absolute increase in risk-adjusted mortality during the study period was relatively small, these findings warrant continued surveillance.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamacardio.2024.3453","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T15:05:27Z","timestamp":1729091127000},"page":"1115","source":"Crossref","is-referenced-by-count":47,"title":["Trends in Transcatheter Aortic Valve Replacement Outcomes"],"prefix":"10.1001","volume":"9","author":[{"given":"Suzanne V.","family":"Arnold","sequence":"first","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, University of Missouri-Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Manandhar","sequence":"additional","affiliation":[{"name":"Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreekanth","family":"Vemulapalli","sequence":"additional","affiliation":[{"name":"Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej S.","family":"Kosinski","sequence":"additional","affiliation":[{"name":"Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne B.","family":"Batchelor","sequence":"additional","affiliation":[{"name":"Inova Heart and Vascular Institute, Falls Church, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod H.","family":"Thourani","sequence":"additional","affiliation":[{"name":"Marcus Heart and Valve Center, Piedmont Heart Institute, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Mack","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Health, Plano, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"St Francis Hospital, Roslyn, New York"},{"name":"Cardiovascular Research Foundation, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"19","key":"hoi240060r1","doi-asserted-by":"publisher","first-page":"2069","DOI":"10.1001\/jama.2013.282043","article-title":"Outcomes following transcatheter aortic valve replacement in the United States.","volume":"310","author":"Mack","year":"2013","journal-title":"JAMA"},{"issue":"21","key":"hoi240060r2","doi-asserted-by":"publisher","first-page":"2492","DOI":"10.1016\/j.jacc.2020.09.595","article-title":"STS-ACC TVT Registry of transcatheter aortic valve replacement.","volume":"76","author":"Carroll","year":"2020","journal-title":"J Am Coll 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