2016 Annual Report of The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry

Abstract

The TVT Registry is an innovative registry that that monitors quality, patient safety and trends for these rapidly evolving new technologies.

Transcatheter Aortic and Mitral Valve‐in‐Valve Implantation Using the Edwards Sapien 3 Heart Valve

“…VIV is also emerging as a treatment option for patients with failed bioprosthesis in the mitral position. Hundreds of patients with failed mitral bioprosthesis have been treated worldwide with the off‐label use of aortic transcatheter heart valves 8, 9…”

Clinical or Symptomatic Leaflet Thrombosis Following Transcatheter Aortic Valve Replacement: Insights from the U.S. FDA MAUDE Database

“…With expanding indications for TAVR, there has been an exponential increase in the number of TAVR procedures in the U.S., with 24,808 TAVRs performed in 2015, compared with 4627 procedures in 2012. 12 The frequency of leaflet thrombosis in prior studies by Latib and co-workers and Córdoba-Soriano and co-workers was low in comparison with the frequency reported in the two recent registry studies (7% in the Danish registry, and 13% in the RESOLVE and SAVORY registries). 3,[13][14][15] However, a diagnosis of leaflet thrombosis in the latter two studies also included the finding of hypoattenuated leaflet thickening on multidetector computed tomography without any clinical manifestations, believed to represent subclinical leaflet thrombosis.…”

Impact of Coronary Artery Revascularization Completeness on Outcomes of Patients With Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement

“…Our results suggest that adequate revascularization pre-TAVR may offer a unique and significant opportunity to improve the prognosis of patients with CAD undergoing TAVR-a finding that is relevant to ≈50% of TAVR patients. 3 A point worth mentioning is that over recent years, the profile of TAVR patients is changing, and as evidence accumulates of the benefit of TAVR for patients at intermediate surgical risk, 30,31 the fraction of patients <80 years old is growing steadily, 1 and this may increase the relative importance and significance of CAD among the myriad of comorbidities in the TAVR population as the life expectancy of younger TAVR patients is expected to increase, which will allow untreated CAD to exert an even more significant effect on survival on the one hand and possibly enhance the benefits of adequate revascularization on the other hand.…”

“…1 Still, TAVR is a complex and costly procedure, associated with mortality rates up to 25% at 1-year and >60% at 5-year follow-up, 2 mainly attributed to the considerable comorbidity burden typical of the TAVR population. Coronary artery disease (CAD) is unique among these comorbidities-it is highly prevalent in the TAVR population (≈50% in large registries and up to 75% in the PARTNER 1 trial [Placement of Aortic Transcatheter Valves trial]) [3][4][5] and, perhaps more importantly, it is potentially more amenable to treatment compared with most recognized predictors of post-TAVR mortality, such as frailty, 6 renal function, 7 obstructive lung disease and atrial fibrillation, 8 thus offering a chance for pre-TAVR intervention that may improve post-TAVR outcomes.…”