• Balloon-expandable transcatheter aortic valve replacement outcomes by procedure location: Catheterization laboratory versus operating room


    • Balloon-expandable TAVR is safe in either procedure location - cath lab or hybrid OR.
    • No difference in procedural and 30-day outcomes between room types
    • Rates of open conversion are minimal for patients of all risk levels.
    • No difference in 30-day mortality in patients of all risk levels post-conversion
    • Balloon-expandable TAVR may be performed in the cath lab to optimize efficiency.



    The impact of procedure location on clinical outcomes after TAVR remains unclear. We aimed to compare short-term outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) in the catheterization laboratory (CATH) versus surgical operating room (OR).


    A retrospective review of 63,581 trans-femoral TAVR patients using balloon-expandable valves from 2015 to 2018 were captured utilizing the TVT Registry. Propensity score matching was performed using 24 covariates resulting in 2 risk-adjusted groups. Patients were further stratified by STS Risk Score with outcomes compared.


    Propensity score matching resulted in 24,160 risk-matched CATH and OR patient pairs. Short-term clinical outcomes including all-cause mortality, stroke, major vascular complications, life-threatening bleeding, and new dialysis were similar between CATH and OR (p = all ns). There was no difference in conversion to open heart surgery between CATH and OR with both occurring at a very low rate (0.4% vs. 0.5%, p = 0.07). Moreover, the 30-day survival post-conversion was similar whether TAVR was performed in CATH versus OR (43.3% and 49.7%, p = 0.28). When stratified by STS Risk Score, there was no difference in conversion to surgery or 30-day mortality in low and intermediate risk patients between CATH and OR. For high risk patients, however, conversion to surgery was lower in CATH vs. OR (0.2% vs. 0.4%, p = 0.04) with no difference in 30-day survival (46% vs. 43%, p = 0.94).


    Procedure location has minimal impact on TAVR procedural and 30-day outcomes with a very low conversion to open surgery rate between CATH versus OR for low, intermediate, and high-risk patients.

    Author bio

    Cardiovascular Revascularization Medicine, 2020-02-01, Volume 21, Issue 2, Pages 149-154, Copyright © 2019 Elsevier Inc.



    Read the full article on Science Direct: Balloon-expandable transcatheter aortic valve replacement outcomes by procedure location: Catheterization laboratory versus operating room

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