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Robust operator experience and a higher volume of transcatheter&nbsp;<a href="https://proddocwire.wpengine.com/cardiology/analysis-ross-procedure/">aortic valve replacement</a>&nbsp;(TAVR) procedures were both associated with better patient safety and more favorable outcomes, new research suggests.&nbsp;&nbsp;Study researchers used data from 16 centers participating in the international TAVR registry, and divided cases into five categories of operator experience (initial, 1 to 75 cases; early,76 to 150 cases; intermediate, 151 to 225 cases; high, 226 to 300 cases; very high, &gt;300 cases) for learning curve characterization. They also&nbsp;stratified&nbsp;annual TAVR case volume into low- (&lt;50), moderate- (50 to 100), and high-volume (&gt;100) groups and collected procedural and 30-day clinical outcomes data. The analysis included 3,403 patients.&nbsp;&nbsp;<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
TAVR performed at low annual volume (&lt;50 procedures) institutions associated with higher mortality. Learn more in <a href="https://twitter.com/hashtag/JACCINT?src=hash&amp;ref_src=twsrc%5Etfw">#JACCINT</a>: <a href="https://t.co/04PXly6x7C">https://t.co/04PXly6x7C</a>. <a href="https://t.co/6nPktKApH9">pic.twitter.com/6nPktKApH9</a>
&mdash; JACC Journals (@JACCJournals) <a href="https://twitter.com/JACCJournals/status/1042097200862507008?ref_src=twsrc%5Etfw">September 18, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>According&nbsp;to the&nbsp;results, all-cause mortality was higher for the first three categories of operator experience (early, low, intermediate) compared to high- and very high-experienced operators. The safety endpoint was worst in all groups except&nbsp;for very&nbsp;high-experience operators. The&nbsp;researchers&nbsp;also reported that low annual TAVR procedure volume (&lt;50 cases) was&nbsp;associated&nbsp;with significantly higher all-cause 30-day mortality (OR=2.70; 95% CI, 1.44 to 5.07) and a worse safety endpoint as well (OR=1.60; 95% CI, 1.17 to 2.17).&nbsp;&ldquo;Transcatheter aortic valve replacement procedures display important learning curve characteristics with both greater procedural safety and a lower mortality when performed by experienced operators,&rdquo; the researchers concluded. &ldquo;In addition, TAVR performed at low annual volume institutions&nbsp;is&nbsp;associated with decreased procedural safety and higher patient&nbsp;<a href="https://proddocwire.wpengine.com/cardiology/five-year-outcomes-of-transcatheter-reduction-of-significant-mitral-regurgitation-in-high-surgical-risk-patients/amp/">mortality.</a>&nbsp;These findings have important implications for operator training and patient care at centers performing TAVR.&rdquo;&nbsp;<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
NOT every hospital should have TAVR program! &#8294;<a href="https://twitter.com/BBHHeart1?ref_src=twsrc%5Etfw">@BBHHeart1</a>&#8297; &#8294;<a href="https://twitter.com/MustafaAhmedMD?ref_src=twsrc%5Etfw">@MustafaAhmedMD</a>&#8297; &#8294;<a href="https://twitter.com/KyleEudaileyMD?ref_src=twsrc%5Etfw">@KyleEudaileyMD</a>&#8297; &#8294;<a href="https://twitter.com/mmamas1973?ref_src=twsrc%5Etfw">@mmamas1973</a>&#8297; &#8294;<a href="https://twitter.com/willsuh76?ref_src=twsrc%5Etfw">@willsuh76</a>&#8297; &#8294;<a href="https://twitter.com/mirvatalasnag?ref_src=twsrc%5Etfw">@mirvatalasnag</a>&#8297; &#8294;<a href="https://twitter.com/SVRaoMD?ref_src=twsrc%5Etfw">@SVRaoMD</a>&#8297; &#8294;<a href="https://twitter.com/DrChuckSimonton?ref_src=twsrc%5Etfw">@DrChuckSimonton</a>&#8297; <a href="https://t.co/P8TLjFzvQM">https://t.co/P8TLjFzvQM</a>
&mdash; Alain Bouchard (@AlainBouchardmd) <a href="https://twitter.com/AlainBouchardmd/status/1036943590667313152?ref_src=twsrc%5Etfw">September 4, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
TAVI performed at low annual volume (&lt;50 procedures) institutions is associated with decreased procedural safety and higher patient mortality. <a href="https://t.co/5KHuPRheH1">https://t.co/5KHuPRheH1</a>
&mdash; Rafa S&aacute;daba (@rafasadaba) <a href="https://twitter.com/rafasadaba/status/1036834666827993088?ref_src=twsrc%5Etfw">September 4, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
TAVR procedures-greater procedural safety &amp; lower mortality when performed by experienced operators. TAVR performed at low annual volume(&lt;50 procedures) institutions is associated with decreased procedural safety &amp; higher patient mortality. 
 <a href="https://t.co/7CW1Kitmn4">https://t.co/7CW1Kitmn4</a>
&mdash; LeeB (@Faithgirlee) <a href="https://twitter.com/Faithgirlee/status/1038098869534515206?ref_src=twsrc%5Etfw">September 7, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Did industry not think to have everyone doing TAVI regardless of the volume? <a href="https://t.co/gObyQHNJVS">https://t.co/gObyQHNJVS</a>
&mdash; Domenico Pagano (@dompagano) <a href="https://twitter.com/dompagano/status/1036838409866813440?ref_src=twsrc%5Etfw">September 4, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>Source: <a href="http://interventions.onlinejacc.org/content/11/17/1669?utm_medium=social&amp;utm_source=twitter_post&amp;utm_campaign=editors_insights&amp;utm_content=10.1016%2Fj.jcin.2018.06.044">JACC Interventions&nbsp;</a>

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Analysis: Operator Experience, Higher Case Volume Yield Better Outcomes

Interventional Cardiology

Robust operator experience and a higher volume of transcatheter aortic valve replacement (TAVR) procedures were both associated with better patient safety and more favorable ...

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