School of Medicine and Health Sciences Poster Presentations
Transcatheter Mitral Valve Replacement Outcomes: Insight From The National Cardiovascular Data Registry
Document Type
Poster
Abstract Category
Cardiology/Cardiovascular Research
Keywords
Cardiology, TMVR, interventional cardiology.
Publication Date
Spring 5-1-2019
Abstract
Transcatheter mitral valve replacement (TMVR) was approved by the FDA in 2013 for patients who are not candidates for surgical mitral valve replacement. Since the FDA approval, the rate of TMVR procedure has increased exponentially across the nation. In this study, we conducted a descriptive analysis for patients who underwent TMVR in The United States to scrutinize the procedural approach and clinical outcomes of this procedure. The National Cardiovascular Data Registry (NCDR) was used to summarize the baseline demographic and health characteristics of all patients who underwent TMVR procedures between 2014 and 2017. The trend and change in the procedure approach, adverse events, and clinical outcomes were summarized and visualized in scatter graphs. The number of subjects who underwent TMVR has raised substantially from 73 subjects in 2014 to 493 in 2017. The baseline rates of hypertension, diabetes, stroke, peripheral vascular disease, end-stage renal disease, and atrial fibrillation have not changed significantly during the last four years. However, the rate of patients low to intermediate STS score has increased during the last four years (24% vs. 42%). Interestingly, there has been a significant shift in the procedural approach from transapical to transseptal. The transseptal approach has increased from 8% in 2014 to 64% in 2017. The procedural duration (155 vs. 141 minutes) and the rate of the procedural success (92% vs. 95%) have also improved during the last four years. Finally, patients who underwent TMVR had significant improvement in the status of their NYHA. The rate of subjects with NYHA III & IV had reduced from 81% before the procedure to 9% within 30 days from the procedure. Transcatheter mitral valve replacement has significantly evolved during the last four years. The rate of TMVR will likely increase further among patients with low to intermediate STS score.
Open Access
1
Transcatheter Mitral Valve Replacement Outcomes: Insight From The National Cardiovascular Data Registry
Transcatheter mitral valve replacement (TMVR) was approved by the FDA in 2013 for patients who are not candidates for surgical mitral valve replacement. Since the FDA approval, the rate of TMVR procedure has increased exponentially across the nation. In this study, we conducted a descriptive analysis for patients who underwent TMVR in The United States to scrutinize the procedural approach and clinical outcomes of this procedure. The National Cardiovascular Data Registry (NCDR) was used to summarize the baseline demographic and health characteristics of all patients who underwent TMVR procedures between 2014 and 2017. The trend and change in the procedure approach, adverse events, and clinical outcomes were summarized and visualized in scatter graphs. The number of subjects who underwent TMVR has raised substantially from 73 subjects in 2014 to 493 in 2017. The baseline rates of hypertension, diabetes, stroke, peripheral vascular disease, end-stage renal disease, and atrial fibrillation have not changed significantly during the last four years. However, the rate of patients low to intermediate STS score has increased during the last four years (24% vs. 42%). Interestingly, there has been a significant shift in the procedural approach from transapical to transseptal. The transseptal approach has increased from 8% in 2014 to 64% in 2017. The procedural duration (155 vs. 141 minutes) and the rate of the procedural success (92% vs. 95%) have also improved during the last four years. Finally, patients who underwent TMVR had significant improvement in the status of their NYHA. The rate of subjects with NYHA III & IV had reduced from 81% before the procedure to 9% within 30 days from the procedure. Transcatheter mitral valve replacement has significantly evolved during the last four years. The rate of TMVR will likely increase further among patients with low to intermediate STS score.
Comments
Presented at Research Days 2019.