Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012

Edward L. Hannan; Zaza Samadashvili; Nicholas J. Stamato; Stephen J. Lahey; Andrew Wechsler; Desmond Jordan; Thoralf M. Sundt; Jeffrey P. Gold; Carlos E. Ruiz; Mohammed H. Ashraf; Craig R. Smith

doi:10.1016/j.jcin.2015.12.022

Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012

Edward L. Hannan, Zaza Samadashvili, Nicholas J. Stamato, Stephen J. Lahey, Andrew Wechsler, Desmond Jordan, Thoralf M. Sundt, Jeffrey P. Gold, Carlos E. Ruiz, Mohammed H. Ashraf, Craig R. Smith

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Objectives The purpose of this study was to investigate changes in the use of transcatheter aortic valve replacement (TAVR) relative to surgical aortic valve replacement (SAVR) and to examine relative 1-year TAVR and SAVR outcomes in 2011 to 2012 in a population-based setting. Background TAVR has become a popular option for patients with severe aortic stenosis, particularly for higher-risk patients. Methods New York's Cardiac Surgery Reporting System was used to identify TAVR and SAVR volumes and to propensity match TAVR and SAVR patients using numerous patient risk factors contained in the registry to compare 1-year mortality rates. Mortality rates were also compared for different levels of patient risk. Results The total number of aortic valve replacement patients increased from 2,291 in 2011 to 2,899 in 2012, an increase of 27%. The volume of SAVR patients increased by 7.1% from 1,994 to 2,135 and the volume of TAVR patients increased 157% from 297 to 764. The percentage of SAVR patients that were at higher risk (≥3% New York State [NYS] score, equivalent to a Society of Thoracic Surgeons score of about 8%) decreased from 27% to 23%, and the percentage of TAVR patients that were at higher risk decreased from 83% to 76%. There was no significant difference in 1-year mortality between TAVR and SAVR patients (15.6% vs. 13.1%; hazard ratio [HR]: 1.30 [95% confidence interval (CI): 0.89 to 1.92]). There were no differences among patients with NYS score <3% (12.5% vs. 10.2%; HR: 1.42 [95% CI: 0.68 to 2.97]) or among patients with NYS score ≥3% (17.1% vs. 14.5%; HR: 1.27 [95% CI: 0.81 to 1.98]). Conclusions TAVR has assumed a much larger share of all aortic valve replacements for severe aortic stenosis, and the average level of pre-procedural risk has decreased substantially. There are no differences between 1-year mortality rates for TAVR and SAVR patients.

Original language	English (US)
Pages (from-to)	578-585
Number of pages	8
Journal	JACC: Cardiovascular Interventions
Volume	9
Issue number	6
DOIs	https://doi.org/10.1016/j.jcin.2015.12.022
State	Published - Mar 28 2016

Keywords

mortality
surgical aortic valve replacement
transcatheter aortic valve implantation

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.jcin.2015.12.022

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Hannan, E. L., Samadashvili, Z., Stamato, N. J., Lahey, S. J., Wechsler, A., Jordan, D., Sundt, T. M., Gold, J. P., Ruiz, C. E., Ashraf, M. H., & Smith, C. R. (2016). Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012. JACC: Cardiovascular Interventions, 9(6), 578-585. https://doi.org/10.1016/j.jcin.2015.12.022

Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012. / Hannan, Edward L.; Samadashvili, Zaza; Stamato, Nicholas J. et al.
In: JACC: Cardiovascular Interventions, Vol. 9, No. 6, 28.03.2016, p. 578-585.

Research output: Contribution to journal › Article › peer-review

Hannan, EL, Samadashvili, Z, Stamato, NJ, Lahey, SJ, Wechsler, A, Jordan, D, Sundt, TM, Gold, JP, Ruiz, CE, Ashraf, MH & Smith, CR 2016, 'Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012', JACC: Cardiovascular Interventions, vol. 9, no. 6, pp. 578-585. https://doi.org/10.1016/j.jcin.2015.12.022

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title = "Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012",

abstract = "Objectives The purpose of this study was to investigate changes in the use of transcatheter aortic valve replacement (TAVR) relative to surgical aortic valve replacement (SAVR) and to examine relative 1-year TAVR and SAVR outcomes in 2011 to 2012 in a population-based setting. Background TAVR has become a popular option for patients with severe aortic stenosis, particularly for higher-risk patients. Methods New York's Cardiac Surgery Reporting System was used to identify TAVR and SAVR volumes and to propensity match TAVR and SAVR patients using numerous patient risk factors contained in the registry to compare 1-year mortality rates. Mortality rates were also compared for different levels of patient risk. Results The total number of aortic valve replacement patients increased from 2,291 in 2011 to 2,899 in 2012, an increase of 27%. The volume of SAVR patients increased by 7.1% from 1,994 to 2,135 and the volume of TAVR patients increased 157% from 297 to 764. The percentage of SAVR patients that were at higher risk (≥3% New York State [NYS] score, equivalent to a Society of Thoracic Surgeons score of about 8%) decreased from 27% to 23%, and the percentage of TAVR patients that were at higher risk decreased from 83% to 76%. There was no significant difference in 1-year mortality between TAVR and SAVR patients (15.6% vs. 13.1%; hazard ratio [HR]: 1.30 [95% confidence interval (CI): 0.89 to 1.92]). There were no differences among patients with NYS score <3% (12.5% vs. 10.2%; HR: 1.42 [95% CI: 0.68 to 2.97]) or among patients with NYS score ≥3% (17.1% vs. 14.5%; HR: 1.27 [95% CI: 0.81 to 1.98]). Conclusions TAVR has assumed a much larger share of all aortic valve replacements for severe aortic stenosis, and the average level of pre-procedural risk has decreased substantially. There are no differences between 1-year mortality rates for TAVR and SAVR patients.",

keywords = "mortality, surgical aortic valve replacement, transcatheter aortic valve implantation",

author = "Hannan, {Edward L.} and Zaza Samadashvili and Stamato, {Nicholas J.} and Lahey, {Stephen J.} and Andrew Wechsler and Desmond Jordan and Sundt, {Thoralf M.} and Gold, {Jeffrey P.} and Ruiz, {Carlos E.} and Ashraf, {Mohammed H.} and Smith, {Craig R.}",

note = "Publisher Copyright: {\textcopyright} 2016 by the American College of Cardiology Foundation.",

year = "2016",

month = mar,

day = "28",

doi = "10.1016/j.jcin.2015.12.022",

language = "English (US)",

volume = "9",

pages = "578--585",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

publisher = "Elsevier Inc.",

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T1 - Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis

T2 - 2011 to 2012

AU - Hannan, Edward L.

AU - Samadashvili, Zaza

AU - Stamato, Nicholas J.

AU - Lahey, Stephen J.

AU - Wechsler, Andrew

AU - Jordan, Desmond

AU - Sundt, Thoralf M.

AU - Gold, Jeffrey P.

AU - Ruiz, Carlos E.

AU - Ashraf, Mohammed H.

AU - Smith, Craig R.

PY - 2016/3/28

Y1 - 2016/3/28

N2 - Objectives The purpose of this study was to investigate changes in the use of transcatheter aortic valve replacement (TAVR) relative to surgical aortic valve replacement (SAVR) and to examine relative 1-year TAVR and SAVR outcomes in 2011 to 2012 in a population-based setting. Background TAVR has become a popular option for patients with severe aortic stenosis, particularly for higher-risk patients. Methods New York's Cardiac Surgery Reporting System was used to identify TAVR and SAVR volumes and to propensity match TAVR and SAVR patients using numerous patient risk factors contained in the registry to compare 1-year mortality rates. Mortality rates were also compared for different levels of patient risk. Results The total number of aortic valve replacement patients increased from 2,291 in 2011 to 2,899 in 2012, an increase of 27%. The volume of SAVR patients increased by 7.1% from 1,994 to 2,135 and the volume of TAVR patients increased 157% from 297 to 764. The percentage of SAVR patients that were at higher risk (≥3% New York State [NYS] score, equivalent to a Society of Thoracic Surgeons score of about 8%) decreased from 27% to 23%, and the percentage of TAVR patients that were at higher risk decreased from 83% to 76%. There was no significant difference in 1-year mortality between TAVR and SAVR patients (15.6% vs. 13.1%; hazard ratio [HR]: 1.30 [95% confidence interval (CI): 0.89 to 1.92]). There were no differences among patients with NYS score <3% (12.5% vs. 10.2%; HR: 1.42 [95% CI: 0.68 to 2.97]) or among patients with NYS score ≥3% (17.1% vs. 14.5%; HR: 1.27 [95% CI: 0.81 to 1.98]). Conclusions TAVR has assumed a much larger share of all aortic valve replacements for severe aortic stenosis, and the average level of pre-procedural risk has decreased substantially. There are no differences between 1-year mortality rates for TAVR and SAVR patients.

AB - Objectives The purpose of this study was to investigate changes in the use of transcatheter aortic valve replacement (TAVR) relative to surgical aortic valve replacement (SAVR) and to examine relative 1-year TAVR and SAVR outcomes in 2011 to 2012 in a population-based setting. Background TAVR has become a popular option for patients with severe aortic stenosis, particularly for higher-risk patients. Methods New York's Cardiac Surgery Reporting System was used to identify TAVR and SAVR volumes and to propensity match TAVR and SAVR patients using numerous patient risk factors contained in the registry to compare 1-year mortality rates. Mortality rates were also compared for different levels of patient risk. Results The total number of aortic valve replacement patients increased from 2,291 in 2011 to 2,899 in 2012, an increase of 27%. The volume of SAVR patients increased by 7.1% from 1,994 to 2,135 and the volume of TAVR patients increased 157% from 297 to 764. The percentage of SAVR patients that were at higher risk (≥3% New York State [NYS] score, equivalent to a Society of Thoracic Surgeons score of about 8%) decreased from 27% to 23%, and the percentage of TAVR patients that were at higher risk decreased from 83% to 76%. There was no significant difference in 1-year mortality between TAVR and SAVR patients (15.6% vs. 13.1%; hazard ratio [HR]: 1.30 [95% confidence interval (CI): 0.89 to 1.92]). There were no differences among patients with NYS score <3% (12.5% vs. 10.2%; HR: 1.42 [95% CI: 0.68 to 2.97]) or among patients with NYS score ≥3% (17.1% vs. 14.5%; HR: 1.27 [95% CI: 0.81 to 1.98]). Conclusions TAVR has assumed a much larger share of all aortic valve replacements for severe aortic stenosis, and the average level of pre-procedural risk has decreased substantially. There are no differences between 1-year mortality rates for TAVR and SAVR patients.

KW - mortality

KW - surgical aortic valve replacement

KW - transcatheter aortic valve implantation

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Utilization and 1-Year Mortality for Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement in New York Patients With Aortic Stenosis: 2011 to 2012

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