The Present and Future
State-of-the-Art Review
STS-ACC TVT Registry of Transcatheter Aortic Valve Replacement

https://doi.org/10.1016/j.jacc.2020.09.595Get rights and content
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Highlights

  • The STS-ACC TVT Registry documents the growth of TAVR in the United States.

  • Low-risk patients and valve-in-valve procedures are rapidly growing subsets of TAVR procedures.

  • The Registry will continue to gather data on the demographics and outcomes of TAVR procedures and allow assessment of the impact of the COVID-19 on patients and health systems involved in this procedure.

Abstract

The STS-ACC TVT Registry (Society of Thoracic Surgeons–American College of Cardiology Transcatheter Valve Therapy Registry) from 2011 to 2019 has collected data on 276,316 patients undergoing transcatheter aortic valve replacement (TAVR) at sites in all U.S. states. Volumes have increased every year, exceeding surgical aortic valve replacement in 2019 (72,991 vs. 57,626), and it is now performed in all U.S. states. TAVR now extends from extreme- to low-risk patients. This is the first presentation on 8,395 low-risk patients treated in 2019. In 2019, for the entire cohort, femoral access increased to 95.3%, hospital stay was 2 days, and 90.3% were discharged home. Since 2011, the 30-day mortality rate has decreased (7.2% to 2.5%), stroke has started to decrease (2.75% to 2.3%), but pacemaker need is unchanged (10.9% to 10.8%). Alive with acceptable patient-reported outcomes is achieved in 8 of 10 patients at 1 year. The Registry is a national resource to improve care and analyze TAVR’s evolution. Real-world outcomes, site performance, and the impact of coronavirus disease 2019 will be subsequently studied. (STS/ACC Transcatheter Valve Therapy Registry [TVT Registry]; NCT01737528)

Key Words

aortic stenosis
outcomes
registry
TAVR
valvular heart disease

Abbreviations and Acronyms

ACC
American College of Cardiology
AR
aortic regurgitation
aRD
adjusted risk difference
CMS
Centers for Medicare & Medicaid Services
COVID-19
coronavirus disease 2019
CPB
cardiopulmonary bypass
DCF
data collection form
FDA
U.S. Food and Drug Administration
IQR
interquartile range
IRB
institutional review board
KCCQ
Kansas City Cardiomyopathy Questionnaire
LOS
length of stay
NCD
National Coverage Determination
NYHA
New York Heart Association
OHS
open heart surgery
SAVR
surgical aortic valve replacement
STS
Society of Thoracic Surgeons
TAVR
transcatheter aortic valve replacement
V-in-V
valve-in-valve

Cited by (0)

This paper has been co-published in The Annals of Thoracic Surgery and the Journal of the American College of Cardiology.

The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.

Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.