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Effect of Availability of TAVR on Clinical Practice Evaluated

Analysis of isolated TAVRs and surgical AV replacements performed in Germany 2007 to 2013

heart model

THURSDAY, Dec. 17, 2015 (HealthDay News) -- The use of transcatheter aortic-valve replacement (TAVR) increased in Germany from 2007 to 2013, with a moderate concomitant reduction in surgical aortic-valve replacement, according to a study published in the Dec. 17 issue of the New England Journal of Medicine.

Jochen Reinöhl, M.D., from the University of Freiburg in Germany, and colleagues analyzed data on characteristics of patients and in-hospital outcomes for isolated TAVR and surgical aortic-valve replacement procedures. Data were included for 32,581 TAVR and 55,992 surgical aortic-valve replacement procedures performed in Germany from 2007 to 2013.

The researchers observed an increase in the number of TAVR procedures, from 144 in 2007 to 9,147 in 2014, and a slight decrease in the number of surgical aortic-valve replacement procedures, from 8,622 to 7,048. Patients undergoing TAVR were older and at higher preoperative risk than those undergoing surgical aortic-valve replacement. In both groups there were decreases in in-hospital mortality from 2007 to 2013 (TAVR: from 13.2 to 5.4 percent; surgical aortic-valve replacement: from 3.8 to 2.2 percent). There were also declines in the incidences of stroke, bleeding, and pacemaker implantation, but not acute kidney injury.

"The use of TAVR increased markedly in Germany between 2007 and 2013; the concomitant reduction in the use of surgical aortic-valve replacement was moderate," the authors write. "In-hospital mortality decreased in both groups but to a greater extent among patients undergoing TAVR."

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