Critical Care Helicopter Overtriage: A Failure Mode and Effects Analysis.
Aged; Humans; Male; Adult; Female; Aged 80 and over; Middle Aged; Infant; Adolescent; Child; Emergency Medical Services; Young Adult; Child Preschool; Quality Improvement; Aircraft; Healthcare Failure Mode and Effect Analysis/methods; Triage/standards; Air Ambulances
OBJECTIVE: Overtriage (OT) of helicopter emergency medical services (HEMS) poses significant burden to multiple stakeholders. The project aims were to identify the following: 1) associated factors, 2) downstream effects, and 3) focus areas for change. METHODS: We undertook a failure mode and effects analysis (FMEA) to evaluate our HEMS interfacility transport process. Data were collected from organizational finances and 3 key stakeholder groups: 1) interfacility patients transferred by HEMS in 2017 who were discharged from the receiving facility within 24 hours (n = 149), 2) flight registered nurses (n = 19), and 3) referring emergency medicine providers (EMPs) (n = 30) from the top HEMS users of 2017. The completed FMEA identified failure modes, the frequency and severity of effects, and unique risk profile numbers (RPNs). RESULTS: Twelve failure modes were identified with 30 potential causes. Leading failure modes included inappropriate HEMS requests by EMPs (RPN = 343), inappropriate activation by EMS for interfacility transport (RPN = 343), and minimizing patient/family involvement in decision making (RPN = 315). Significant burdens to organizational finances and flight registered nurse satisfaction were identified. CONCLUSION: Associated factors for interfacility HEMS OT, downstream effects, and areas for change were identified. EMP and emergency medical services practices, HEMS processes, and shared decision making may affect regional OT rates.
Grabowski RL; McNett M; Ackerman MH; Schubert C; Mion LC
Air Medical Journal
2019
2019-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1016/j.amj.2019.07.012" target="_blank" rel="noreferrer noopener">10.1016/j.amj.2019.07.012</a>
Perioperative Safety of Surgery for Pelvic Organ Prolapse in Elderly and Frail Patients.
Aged; Humans; Female; Aged 80 and over; Middle Aged; Postoperative Complications/etiology; Gynecologic Surgical Procedures/adverse effects; Patient Safety; Frailty/complications; Pelvic Organ Prolapse/surgery; Perioperative Period
OBJECTIVE: To evaluate the effects of old age and frailty on complication rates after surgery for pelvic organ prolapse. METHODS: The American College of Surgeons' National Surgical Quality Improvement Program database was used to identify patients who underwent surgery for prolapse from 2010 to 2017. We compared our control group (45-64 years, index population) to those aged 65-79 years (elderly) and 80 years and older (very elderly). Frailty was assessed using the National Surgical Quality Improvement Program Modified Frailty Index-5. The primary outcome was the composite rate of serious complications and mortality. RESULTS: We analyzed 27,403 patients in the index population, 20,567 in the elderly group, and 3,088 in the very elderly group. The composite rate of serious complications in the index population was 4.5%, compared with 4.7% in the elderly group (odds ratio [OR] 1.0, 95% CI 0.9-1.1) and 9.0% in the very elderly group (OR 2.1, 95% CI 1.8-2.4). Compared with the index group, the very elderly group had notably elevated risks of cardiac complications (OR 11.9, 95% CI 6.2-23.0), stroke (OR 26.6, 95% CI 5.4-131.8), and mortality (OR 39.9, 95% CI 8.6-184.7). On multivariate logistic regression, the only age group independently associated with serious complications was the very elderly group (adjusted odds ratio [aOR] 2.01, 95% CI 1.8-2.3). The Modified Frailty Index-5 score was independently predictive of complications (aOR 1.4, 95% CI 1.1-2.0). Stratified analysis using interaction terms revealed the Modified Frailty Index-5 score to be predictive of complications in the elderly age group (aOR 2.5, 95% CI 1.3-4.6), but not in the very elderly group. CONCLUSION: Serious complications surrounding prolapse surgery increase substantially in the cohort of patients older than 80 years of age, independent of frailty and medical or surgical risk factors.
Chapman GC; Sheyn D; Slopnick EA; Hijaz AK; Mahajan ST; Mangel J; El-Nashar SA
Obstetrics and Gynecology
2020
2020-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1097/aog.0000000000003682" target="_blank" rel="noreferrer noopener">10.1097/aog.0000000000003682</a>
Final Two-Year Outcomes for the Sentry Bioconvertible Inferior Vena Cava Filter in Patients Requiring Temporary Protection from Pulmonary Embolism.
Aged; Humans; Male; Adult; Female; Aged 80 and over; United States; Risk Factors; Middle Aged; Treatment Outcome; Time Factors; Young Adult; Prosthesis Design; Vena Cava Filters; Phlebography; Computed Tomography Angiography; Belgium; Chile; Vena Cava Inferior/diagnostic imaging; Prosthesis Implantation/adverse effects/instrumentation; Pulmonary Embolism/diagnostic imaging/prevention & control; Venous Thrombosis/diagnostic imaging/prevention & control
PURPOSE: To report final 2-year outcomes with the Sentry bioconvertible inferior vena cava (IVC) filter in patients requiring temporary protection against pulmonary embolism (PE). MATERIALS AND METHODS: In a prospective multicenter trial, the Sentry filter was implanted in 129 patients with documented deep vein thrombosis (DVT) and/or PE (67.5%) or who were at temporary risk of developing DVT/PE (32.6%). Patients were monitored and bioconversion status ascertained by radiography, computed tomography (CT), and CT venography through 2 years. RESULTS: The composite primary 6-month endpoint of clinical success was achieved in 97.4% (111/114) of patients. The rate of new symptomatic PE was 0% (n = 126) through 1 year and 2.4% (n = 85) through the second year of follow-up, with 2 new nonfatal cases at 581 and 624 days that were adjudicated as not related to the procedure or device. Two patients (1.6%) developed symptomatic caval thrombosis during the first month and underwent successful interventions without recurrence. No other filter-related symptomatic complications occurred through 2 years. There was no filter tilting, migration, embolization, fracture, or caval perforation and no filter-related deaths through 2 years. Filter bioconversion was successful for 95.7% (110/115) of patients at 6 months, 96.4% (106/110) of patients at 12 months, and 96.5% (82/85) of patients at 24 months. Through 24 months of follow-up, there was no evidence of late-stage IVC obstruction or thrombosis after filter bioconversion or of thrombogenicity associated with retracted filter arms. CONCLUSIONS: The Sentry IVC filter provided safe and effective protection against PE, with a high rate of intended bioconversion and a low rate of device-related complications, through 2 years of follow-up.
Dake MD; Murphy TP; Krämer AH; Darcy MD; Sewall LE; Curi MA; Johnson MS; Arena F; Swischuk JL; Ansel GM; Silver MJ; Saddekni S; Brower JS; Mendes R
Journal of Vascular and Interventional Radiology
2020
2020-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1016/j.jvir.2019.08.036" target="_blank" rel="noreferrer noopener">10.1016/j.jvir.2019.08.036</a>
Safety and efficacy of transcatheter aortic valve replacement for native aortic valve regurgitation: A systematic review and meta-analysis.
Female; Humans; Male; Aged; Middle Aged; Treatment Outcome; Risk Factors; Aged 80 and over; Risk Assessment; Prosthesis Design; Recovery of Function; Heart Valve Prosthesis; Aortic Valve/diagnostic imaging/physiopathology/surgery; aortic valve insufficiency; heart diseases; heart valve prosthesis; Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality; Aortic Valve Insufficiency/diagnostic imaging/mortality/physiopathology/surgery
OBJECTIVE: The objective of this study was to analyze the available literature on using transcatheter aortic valve replacement (TAVR) for native aortic regurgitation (AR). BACKGROUND: Surgical aortic valve replacement is the gold standard therapy for native AR. TAVR has emerged as an alternative approach in high-risk patients. METHODS: MEDLINE, Scopus, and Cochrane CENTRAL were searched for reports of at least 5 patients undergoing TAVR for native AR. Outcomes included 30-day mortality, myocardial infarction, stroke, major bleeding, postprocedural moderate to severe AR, and device success. Pooled estimates were calculated using a random-effects model. Subgroup analysis and a meta-regression were performed to study the effects of study level covariates on outcomes. RESULTS: Nineteen studies (n =998 patients) were included. The rate of procedural success per Valve Academic Research Consortium - 2 (VARC-2) criteria was 86.2% (78.8%-92.2%]. Thirty-day mortality was 11.9% (9.4%-14.7%). Subgroup analysis showed the use of new generation valves was associated with lower 30-day mortality (P = 0.02) and higher device success (P = 0.009) compared with early generation valves. There was no significant difference (P = 0.13) in the rate of 30-day mortality between patients receiving purpose-specific [8.2% (4.3%-13.1%); I2 = 0%] and nonpurpose specific valves [13.0% (8.2%-18.6%); I2 = 25%]. However, device success was higher (P = 0.02) in patients who received purpose-specific valves [96.3% (92.2%-98.9%); I2 = 0%] compared with nonpurpose specific valves [84.4% (75%-91.9%); I2 =46%]. CONCLUSION: TAVR for native AR is associated with acceptable procedural success but increased early mortality. However, the safety and the efficacy of the procedure increased with newer valves.
Rawasia WF; Khan MS; Usman MS; Siddiqi TJ; Mujeeb FA; Chundrigar M; Kalra A; Alkhouli M; Kavinsky CJ; Bhatt DL
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
2019
2019-02-01
© 2018 Wiley Periodicals, Inc.
journalArticle
<a href="http://doi.org/10.1002/ccd.27840" target="_blank" rel="noreferrer noopener">10.1002/ccd.27840</a>
PMID: 30269437
Impact of residual coronary atherosclerosis on transfemoral transcatheter aortic valve replacement.
Female; Humans; Male; Aged; Retrospective Studies; Treatment Outcome; Risk Factors; Time Factors; Aged 80 and over; Patient Readmission; Risk Assessment; Cause of Death; Coronary Artery Disease/diagnostic imaging/mortality/therapy; AVD - aortic valve disease; CAD - coronary artery disease; Catheterization Peripheral/adverse effects/mortality; Femoral Artery; PCI - percutaneous coronary intervention (PCI); Percutaneous Coronary Intervention/adverse effects/mortality; percutaneous intervention; Transcatheter Aortic Valve Replacement/adverse effects/mortality; Aortic Valve Stenosis/diagnostic imaging/mortality/physiopathology/surgery; Aortic Valve/diagnostic imaging/physiopathology/surgery; Punctures
OBJECTIVES: This study reports on the clinical effects of complete vs incompletely revascularized coronary artery disease on transcatheter aortic valve replacement (TAVR). BACKGROUND: There is a high prevalence of active coronary artery disease (CAD) in patients undergoing TAVR but preemptive revascularization remains controversial. METHODS: Patients were categorized into three cohorts: complete revascularization (CR), incomplete revascularization of a major epicardial artery (IR Major), and incomplete revascularization of a minor epicardial artery only (IR Minor). When feasible, SYNTAX scoring was performed for exploratory analysis. Analyses were performed using Cox proportional hazard models and Kaplan-Meier method. RESULTS: A total of 323 patients with active CAD were included. Adjusted outcomes showed that patients with IR Major had increased incidence of acute myocardial infarction (AMI) or revascularization compared with those in the CR cohort (HR 3.72, P = 0.048). No difference was noted in all-cause mortality or all-cause readmission rates. Exploratory secondary analysis with residual SYNTAX scores showed a significant interaction between disease burden and AMI/revascularization, as well as all-cause readmission. All-cause mortality remained unaffected based on residual SYNTAX scores. CONCLUSIONS: This is a retrospective single-center study reporting on pre-TAVR revascularization outcomes in patients with active CAD. In this analysis, we found that patients undergoing TAVR benefited from achieving complete revascularization to abate future incidence of AMI/revascularization. Despite this finding, all-cause mortality remained unaffected. Future efforts should focus on the role of functional assessment of the coronaries, as well as the long-term effects of complete revascularization in a larger patient cohort.
Li Jun; Patel SM; Nadeem F; Thakker P; Al-Kindi SG; Thomas R; Makani A; Hornick JM; Patel T; Lipinski J; Ichibori Y; Davis A; Markowitz AH; Bezerra HG; Simon DI; Costa MA; Kalra A; Attizzani GF
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
2019
2019-02-15
© 2018 Wiley Periodicals, Inc.
journalArticle
<a href="http://doi.org/10.1002/ccd.27894" target="_blank" rel="noreferrer noopener">10.1002/ccd.27894</a>
PMID: 30312990
Outcomes among patients with heart failure with reduced ejection fraction undergoing transcatheter aortic valve replacement: Minimally invasive strategy versus conventional strategy.
Female; Humans; Male; Aged; Retrospective Studies; Treatment Outcome; Prognosis; Cohort Studies; Severity of Illness Index; Aged 80 and over; Logistic Models; Survival Rate; Length of Stay; Multivariate Analysis; Risk Assessment; Reference Values; Hospital Mortality; aortic stenosis; transcatheter aortic valve replacement; heart failure; Transcatheter Aortic Valve Replacement/methods/mortality; anesthesia; conscious sedation; Aortic Valve Stenosis/diagnostic imaging/epidemiology/therapy; Cardiac Catheterization/methods; Cardiac Output Low/diagnostic imaging; Conscious Sedation/methods; Echocardiography Transesophageal/methods; Heart Failure/diagnosis/epidemiology/therapy; Minimally Invasive Surgical Procedures/methods; Surgery Computer-Assisted/methods
OBJECTIVES: To investigate the effect of TAVR technique on in-hospital and 30-day outcomes in patients with aortic stenosis (AS) and reduced ejection fraction (EF). BACKGROUND: Patients with AS and concomitant low EF may be at risk for adverse hemodynamic effects from general anesthesia utilized in transcatheter aortic valve replacement (TAVR) via the conventional strategy (CS). These patients may be better suited for the minimally invasive strategy (MIS), which employs conscious sedation. However, data are lacking that compare MIS to CS in patients with AS and concomitant low EF. METHODS: In this retrospective study, we identified all patients with low EF (<50%) undergoing transfemoral MIS-TAVR vs CS-TAVR between March 2011 and May 2018. Our primary endpoint was defined as the composite of in-hospital mortality and major periprocedural bleeding or vascular complications. RESULTS: Two hundred and seventy patients had EF <50%, while 154 patients had EF ≤35%. Overall, a total of 236 patients were in the MIS group and 34 were in the CS group. Baseline characteristics between the two groups were similar except for Society of Thoracic Surgeons (STS) score (MIS 8.4 ± 5.1 vs CS 11.7 ± 6.8; P<.01). There were no differences between the two groups in incidence of the primary endpoint (MIS 5.5% vs CS 8.8%; odds ratio for MIS, 0.60; 95% confidence interval, 0.16-2.23; P=.45). CONCLUSIONS: In patients with severe AS and reduced EF, MIS was not associated with adverse in-hospital or 30-day clinical outcomes compared with CS. In these patients, MIS may be a suitable alternative to CS without compromising clinical outcomes.
Panhwar MS; Li J; Zidar DA; Clevenger J; Lipinski J; Patel TR; Karim A; Saric P; Patel SM; Kalra A; Attizzani GF
The Journal of invasive cardiology
2019
2019-03
Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
journalArticle
<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
PMID: 30555054
Short-term and long-term outcomes of patients undergoing urgent transcatheter aortic valve replacement under a minimalist strategy.
Female; Humans; Male; Retrospective Studies; Treatment Outcome; Risk Factors; United States/epidemiology; Follow-Up Studies; Severity of Illness Index; Time Factors; Aged 80 and over; Length of Stay; transcatheter aortic valve replacement; Transcatheter Aortic Valve Replacement/methods; minimalist approach; Hospital Mortality/trends; severe aortic stenosis; urgent procedure; Aortic Valve Stenosis/diagnosis/mortality/surgery; Aortic Valve/diagnostic imaging/surgery; Cardiac Catheterization/methods; Echocardiography Transesophageal; Elective Surgical Procedures/methods; Femoral Artery
OBJECTIVES: Urgent transcatheter aortic valve replacement (TAVR) is associated with worse short-term outcomes compared with elective TAVR; however, little is known about long-term outcomes or the safety of the minimalist strategy in this setting. This study investigated the short-term and long-term outcomes of urgent TAVR compared with elective TAVR under a minimalist strategy (transfemoral [TF] approach with conscious sedation and no transesophageal echocardiography guidance). METHODS: After excluding 2 emergent patients requiring immediate procedures, a total of 474 consecutive patients underwent elective TF-TAVR (396 patients; 83.6%) or urgent
Ichibori Y; Li J; Patel T; Lipinski J; Ladas T; Saric P; Kobe D; Tsushima T; Peters M; Patel S; Davis A; Markowitz AH; Bezerra HG; Costa MA; Kalra A; Attizzani GF
The Journal of invasive cardiology
2019
2019-02
Copyright © 2019 Elsevier Inc. All rights reserved.
journalArticle
<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
PMID: 30700628
Feasibility and safety of adopting next-day discharge as first-line option after transfemoral transcatheter aortic valve replacement.
Female; Humans; Male; Aged; Retrospective Studies; Cohort Studies; Follow-Up Studies; Severity of Illness Index; Time Factors; United States; Aged 80 and over; Survival Analysis; Patient Readmission/statistics & numerical data; Propensity Score; Ohio; Academic Medical Centers; Risk Assessment; Feasibility Studies; Patient Discharge; aortic stenosis; transcatheter aortic valve replacement; Length of Stay; early discharge; minimalist approach; next-day discharge; Patient Safety; Aortic Valve Stenosis/diagnosis/surgery; Transcatheter Aortic Valve Replacement/methods/mortality
OBJECTIVES: Data on next-day discharge (NDD) after transcatheter aortic valve replacement (TAVR) are limited. This study investigated the feasibility and safety of NDD as a first-line option (the very-early discharge [VED] strategy) compared with the early-discharge (ED) strategy (2-3 days as a first-line option) after TAVR. METHODS: We reviewed 611 consecutive patients who had minimalist TAVR (transfemoral approach under conscious sedation) and no in-hospital mortality; a total of 418 patients underwent ED strategy (since December 2013) and 193 patients underwent VED strategy (as part of a hospital initiative to reduce length of stay, since August 2016). NDD in the VED strategy was performed with heart team consensus in patients without significant complications. The primary outcome was a composite of 30-day all-cause mortality/rehospitalization. RESULTS: Sixty-five patients (33.7%) in the VED strategy and 10 patients (2.4%) in the ED strategy were discharged the next day (P<.001). NDD patients had received balloon-expandable (n = 30) or self-expanding valves (n = 45) and showed a similar primary outcome rate compared with non-NDD patients. After adjustment using propensity score matching (172 pairs), post-TAVR length of stay was significantly shorter in the VED group (3.2 ± 3.1 days) than in the ED group (3.5 ± 2.7 days; P<.01). The primary outcome did not differ between the two groups (7.0% vs 11.6%; P=.14), with comparable 30-day mortality rate (1.2% vs 2.3%; P=.68) and rehospitalization rate (5.8% vs 11.1%; P=.08). CONCLUSIONS: Utilization of NDD as a first-line option after minimalist TAVR is feasible and safe, and leads to further reduction in length of stay compared with an ED strategy.
Ichibori Y; Li J; Davis A; Patel TM; Lipinski J; Panhwar M; Saric P; Qureshi G; Patel SM; Sareyyupoglu B; Markowitz AH; Bezerra HG; Costa MA; Zidar DA; Kalra A; Attizzani GF
The Journal of invasive cardiology
2019
2019-03
© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.
journalArticle
<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
PMID: 30819977
Stability after initial decline in coronary revascularization rates in the united states.
Female; Humans; Male; Aged; Middle Aged; United States; Aged 80 and over; Coronary Artery Bypass/statistics & numerical data; Percutaneous Coronary Intervention/statistics & numerical data; Procedures and Techniques Utilization/statistics & numerical data
BACKGROUND: It remains uncertain how advances in revascularization techniques, availability of new evidence, and updated guidelines have influenced the annual rates of coronary revascularization in the United States. METHODS: We used the Nationwide Inpatient Sample data from 2005 to 2014 with appropriate weighting to determine national procedural volumes. To present accurately overall percutaneous coronary intervention (PCI) rates, PCI with same-day discharge numbers per year were estimated from the available literature and added to annual PCI procedures performed. RESULTS: Annual PCI rate declined from 353 per 100,000 adults in 2005 to 277 per 100,000 adults in 2009 (P < .001) but remained stable thereafter (P = .50). Annual coronary artery bypass grafting (CABG) rate declined steadily, at a shallower slope than PCI, from 120 per 100,000 in 2005 to 93 per 100,000 in 2009 (P = .02) but remained stable thereafter (P = .60). Similar trends were seen in men and women. Both PCI and CABG rates were lower in women than men over the study period (PCI, 482 to 324/100,000 in men vs 232 to 153/100,000 in women; CABG, 172 to 118/100,000 in men vs 64 to 38/100,000 in women). Annual PCI rates were higher than CABG rates in patients of all age groups including in younger patients (age < 50) and octogenarians. The proportion of coronary revascularization procedures performed per insurance type remained relatively similar across the study period. CONCLUSIONS: Annual rates of coronary revascularization have changed significantly over time, potentially because of advances in revascularization techniques, availability of new evidence, and updated guidelines. Rates of PCI declined more steeply than CABG before plateauing but remained higher than rates of CABG across the study period.
Raza S; Deo VS; Kalra A; Zia A; Altarabsheh SE; Deo VS; Mustafa RR; Younes A; Rao SV; Markowitz AH; Park SJ; Costa MA; Simon DI; Bhatt DL; Sabik JF 3rd
The Annals of thoracic surgery
2019
2019-11
Copyright © 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
journalArticle
<a href="http://doi.org/10.1016/j.athoracsur.2019.03.080" target="_blank" rel="noreferrer noopener">10.1016/j.athoracsur.2019.03.080</a>
PMID: 31039350
The changing landscape of aortic valve replacement in the usa.
Adolescent; Female; Humans; Male; Adult; Aged; Treatment Outcome; Risk Factors; United States; Aged 80 and over; Aortic Valve; Aortic Valve Stenosis; Transcatheter Aortic Valve Replacement
AIMS: The aim of this study was to analyse the real-world national data on parallel utilisation of transcatheter (TAVR) and surgical (SAVR) aortic valve replacement. METHODS AND RESULTS: We queried an all-payer, administrative United States in-patient database to identify all AVR hospitalisations in patients aged ≥18 years from January 2012 to December 2016 and examined the temporal changes in the number of AVR procedures and in-hospital mortality. A total of 463,675 AVRs were performed - 363,275 (78.4%) SAVR and 100,400 (21.6%) TAVR. AVR linearly increased (from 78,985 in 2012 to 103,415 in 2016; +30.9%; ptrend<0.001) largely due to a marked increase in TAVR (from 7,655 to 33,545; +338%; ptrend<0.001), whereas the absolute number of SAVRs remained relatively stable (from 71,330 to 69,870; -1%; ptrend<0.001). The number of TAVRs increased in all pre-specified age groups (<75, 75-79, 80-85, and ≥85 years; ptrend<0.001 for all). In contrast, the number of SAVRs increased modestly in patients aged <75 years (ptrend<0.001) and declined in those aged 75-79 years, 80-84 years, or ≥85 years (ptrend<0.001 for all). Age- and sex-adjusted in-hospital mortality after isolated (aOR 1.00 [0.95-1.05]; ptrend=0.96) or combined SAVR (aOR 1.01 [0.97-1.05]; ptrend=0.66) remained unchanged during the study period, whereas in-hospital mortality after TAVR declined (aOR 0.75 [0.70-0.79]; ptrend<0.001). Similar trends in in-hospital mortality were seen in the age subgroups. CONCLUSIONS: The number of AVRs markedly increased in the USA from 2012 to 2016, mainly due to the widespread adoption of TAVR, whereas the number of SAVRs remained relatively stable. In-hospital mortality after TAVR declined, whereas that after SAVR has remained unchanged.
Gupta T; Kolte D; Khera S; Goel K; Villablanca PA; Kalra A; Abbott JD; Elmariah S; Fonarow GC; Rihal CS; Garcia MJ; Weisz G; Bhatt DL
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
2019
2019-12-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.4244/EIJ-D-19-00381" target="_blank" rel="noreferrer noopener">10.4244/EIJ-D-19-00381</a>
PMID: 31403460