Edgerton, James

Harrington, Katherine

Herbert, Morley

Holper, Elizabeth Mary

Kim, Rebeca

Mack, Michael

Prince, Syma

Szerlip, Molly

Worley, Christina

Elsevier - Publisher Connector 

TCT@ACC-i2: Interventional Cardiology
A1785
JACC March 17, 2015
Volume 65, Issue 10S
mortality trends over time with transCatheter versUs sUrGiCal aortiC valve 
replaCement
Poster Contributions
Poster Hall B1
Saturday, March 14, 2015, 3:45 p.m.-4:30 p.m.
Session Title: Coronary II
Abstract Category: 30. TCT@ACC-i2: Aortic Valve Disease
Presentation Number: 2101-298
Authors: Elizabeth Mary Holper, Molly Szerlip, Morley Herbert, Christina Worley, Rebeca Kim, Syma Prince, James Edgerton, Katherine 
Harrington, Michael Mack, Cardiopulmonary Research Science and Technology Institute, Dallas, TX, USA, USA
background:  The temporal trend in patient profile and clinical use of transcatheter aortic valve replacement (TAVR) versus surgical aortic 
valve replacement (SAVR) is currently unknown. We aim to evaluate the risk factor profile, and risk-adjusted mortality rate of patients 
referred for TAVR versus SAVR over time, starting with the early TAVR experience. 
methods:  Data from consecutive TAVR and SAVR procedures from 2007-2013 at a single-center, high-volume TAVR site was evaluated 
for trends in risk-adjusted mortality, using the Society of Thoracic Surgery (STS) observed/expected ratio in TAVR and SAVR. The STS 
predicted risk of mortality (PROM) was also evaluated over time for TAVR versus SAVR. 
results:  Over time the STS PROM in TAVR patients had some variability, but remained high, ranging from 8.7% to 11.3%. The STS 
PROM in SAVR patients declined steadily since 2009 from 6.7% to 3.6%. (Figure, right) The Risk-adjusted mortality for SAVR since 2009 
decreased steadily, parallel to the reduction in PROM. However, the risk-adjusted mortality of TAVR also varied over time, but since 2010 
has been consistently higher than that of SAVR. (Figure, left) 
Conclusion:  While still less than 1.0, over time the risk-adjusted mortality for TAVR has surpassed that of SAVR. Given the almost 2 fold 
higher PROM in TAVR patients compared to SAVR throughout the study years, separation of high-risk patients for TAVR has allowed SAVR 
outcomes to improve.
 


MORTALITY TRENDS OVER TIME WITH TRANSCATHETER VERSUS SURGICAL AORTIC VALVE REPLACEMENT 

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MORTALITY TRENDS OVER TIME WITH TRANSCATHETER VERSUS SURGICAL AORTIC VALVE REPLACEMENT

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