Urgent TAVR Has Beneficial Outcomes Compared With Elective TAVR

Recent research presented at the ACC 2018 Scientific Session found that urgent or emergent transcatheter aortic valve replacement (TAVR) has acceptable outcomes when compared with elective TAVR. 

“This study reports that despite patients undergoing urgent/emergent TAVR having higher burden of comorbidities and predicted risk of mortality score, acute device success was high and not clinically different compared with elective TAVR,” Dhaval Kolte, MD, PhD, of the division of cardiology at Brown University, and colleagues wrote.

The researchers used CMS data from the Society of Thoracic Surgeons/American College of Cardiology (STS/ACC) transcatheter valve therapy (TVT) Registry to identify 3,952 urgent/emergent TAVR patients among 40,042 overall TAVR patients. They comparatively assessed and device success rate, in-hospital major adverse events, and 30-day and 1-year mortality between urgent and elective TAVR patients. 

Study results showed that device success was statistically lower among urgent TAVR patients; however, device success was not clinically different between the two groups. Other major outcomes, such as life-threatening bleeding, major vascular complication, myocardial infarction, and stroke were similar between the urgent and elective TAVR groups. 

The researchers concluded that urgent TAVR is feasible and has acceptable outcomes compared with elective TAVR. 

“It seems that urgent/emergent TAVR may be a reasonable option in a selected group of patients with severe aortic stenosis,” Dr Kolte and colleagues concluded. “However, additional studies are needed to identify patients who may benefit from urgent/emergent TAVR, and to compare outcomes of emergent TAVR versus emergent balloon aortic valvuloplasty followed by elective TAVR (staged procedure).”