Hospital volume of SAVR linked to better patient outcomes for TAVR

Editor's Note

Hospitals with high volumes of surgical aortic valve replacements (SAVRs) are more likely to be fast adopters of transcatheter aortic valve replacement procedures (TAVRs), and accumulating SAVR and TAVR caseloads is associated with better survival after TAVR, this study finds.

Using Medicare data on 60,538 TAVR procedures performed in 438 hospitals between October 1, 2011, and December 31, 2015, researchers found in adjusted analysis that high hospital SAVR volume alone was not associated with better outcomes after TAVR. However, when TAVR and SAVR volumes were jointly  analyzed, those treated in hospitals with high TAVR volume had lower 30-day mortality after TAVR, and the effect was more pronounced when hospitals also had high SAVR volume.

This is the first study that comprehensively evaluates the association of SAVR volume and the use and outcomes of TAVR, the researchers say. The analysis emphasizes the role of both SAVR and TAVR volumes, which has important policy implications when determining volume requirements.