{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:34:58Z","timestamp":1761863698037},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,22]],"date-time":"2017-03-22T00:00:00Z","timestamp":1490140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["1K23HL118138"],"award-info":[{"award-number":["1K23HL118138"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to assess the national uptake of TAVR, associated in\u2010hospital outcomes, and the effect of procedural experience on outcomes in the first two years following device approval.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Transcatheter aortic valve replacement (TAVR) is a newly established therapy for high\u2010risk patients with severe aortic stenosis. Evaluating the manner in which TAVR has disseminated into real\u2010world practice is essential for understanding its impact on population health.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We identified patients undergoing TAVR from the National Inpatient Sample from January 2012 through December 2013. During this period, an estimated 21,185 cases were performed in the United States. Mean age was 81.1 years, 50.8% were male, 86.5% were Caucasian, and 89.6% were Medicare patients. The number of TAVRs performed and of hospitals performing the procedure nationally grew linearly throughout the study period. The most frequent complications included bleeding (26.9%), respiratory failure (19.3%), and renal\/metabolic issues (17.2%). Median hospital length of stay was 6 days (IQR 4\u201010). In\u2010hospital mortality was estimated to be 4.9%. A majority of cases were performed in large (80.8%) and in urban teaching (87%) hospitals. In the first year post\u2010market approval, prior institutional experience with TAVR was associated with significantly reduced risk\u2010adjusted, in\u2010hospital mortality (OR 0.82 per 25 additional TAVRs performed, CI 0.70\u20100.951, <jats:italic>P<\/jats:italic>\u2009=\u20090.009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Following device approval, the number of TAVRs and hospitals performing TAVR grew dramatically. Procedural complications were frequent and in\u2010hospital mortality was approximately 4.9%. Finally, increased procedural experience was strongly associated with a reduction in inpatient mortality. \u00a9 2017 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27018","type":"journal-article","created":{"date-parts":[[2017,3,22]],"date-time":"2017-03-22T23:27:14Z","timestamp":1490225234000},"page":"830-838","source":"Crossref","is-referenced-by-count":2,"title":["Utilization and outcomes of transcatheter aortic valve replacement in the United States shortly after device approval"],"prefix":"10.1002","volume":"90","author":[{"given":"Michael N.","family":"Young","sequence":"first","affiliation":[{"name":"Cardiology Division Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sammy","family":"Elmariah","sequence":"additional","affiliation":[{"name":"Cardiology Division Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin F.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, University of Missouri\u2010Kansas City Kansas City Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"Inglessis","sequence":"additional","affiliation":[{"name":"Cardiology Division Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1313875"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60211-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.66.5.1105"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.12.005"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1202277"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200384"},{"key":"e_1_2_7_10_1","unstructured":"U.S. Food and Drug Administration | Medical Devices | Edwards SAPIEN Transcatheter Heart Valve (THV) \u2010 P100041.wayback.archive-it.org\/7993\/20170112091714\/http:\/\/www.fda.gov\/MedicalDevices\/ProductsandMedicalProcedures\/DeviceApprovalsandClearances\/Recently-ApprovedDevices\/ucm280840.htm. Accessed October 9 2014."},{"key":"e_1_2_7_11_1","unstructured":"FDA Approves Expanded Indication for Edwards Lifesciences' Transcatheter Valve.http:\/\/www.edwards.com\/ns20121019. Accessed October 16 2014."},{"key":"e_1_2_7_12_1","volume-title":"Healthcare Cost and Utilization Project (HCUP). 2012\u20102013","author":"HCUP National Inpatient Sample (NIS)"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"e_1_2_7_14_1","volume-title":"HCUP Methods Series Report # 2004\u20101","author":"Elixhauser A","year":"2004"},{"key":"e_1_2_7_15_1","volume-title":"HCUP Methods Series Report # 2014\u201004 ONLINE","author":"R Houchens","year":"2014"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3841"},{"key":"e_1_2_7_17_1","volume-title":"Healthcare Cost and Utilization Project (HCUP)","author":"HCUP Methods Series","year":"2014"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.282043"},{"key":"e_1_2_7_19_1","unstructured":"STS\/ACC TVT Registry|An initiative of the STS National Database and the ACC's NCDR.https:\/\/www.ncdr.com\/TVT\/Home. Accessed October 8 2014."},{"key":"e_1_2_7_20_1","unstructured":"STS and ACC Launch Joint Clinical Registry for Transcatheter Valve Therapy in the United States.http:\/\/www.sts.org\/news\/sts-and-acc-launch-joint-clinical-registry-transcatheter-valve-therapy-united-states. Accessed October 8 2014."},{"key":"e_1_2_7_21_1","unstructured":"National Coverage Determination (NCD) for Transcatheter Aortic Valve Replacement (TAVR) (20.32).http:\/\/www.cms.gov\/medicare-coverage-database. Accessed October 8 2014."},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25394"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.27018","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.27018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T03:56:48Z","timestamp":1696046208000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.27018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,22]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1002\/ccd.27018"],"URL":"https:\/\/doi.org\/10.1002\/ccd.27018","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,22]]}}}