Faculty Opinions recommendation of Aortic valve bypass surgery: midterm clinical outcomes in a high-risk aortic stenosis population.

2008 ◽  
Author(s):  
John A Paraskos
Keyword(s):  
High Risk ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Clinical Outcomes ◽  
Bypass Surgery ◽  
Aortic Valve Bypass

Aortic Valve Bypass for the High-Risk Patient With Aortic Stenosis

2006 ◽  
Vol 81 (5) ◽  
pp. 1605-1610 ◽  
Author(s):  
James S. Gammie ◽  
John W. Brown ◽  
Jamie M. Brown ◽  
Robert S. Poston ◽  
Richard N. Pierson ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
High Risk Patient ◽  
Risk Patient ◽  
Aortic Valve Bypass

Outcomes of Off-Pump Aortic Valve Bypass Surgery for the Relief of Aortic Stenosis in Adults

2011 ◽  
Vol 91 (1) ◽  
pp. 131-136 ◽  
Author(s):  
Vinod H. Thourani ◽  
W. Brent Keeling ◽  
Robert A. Guyton ◽  
Ameesh Dara ◽  
Stuart D. Hurst ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Bypass Surgery ◽  
Off Pump ◽  
Aortic Valve Bypass

Aortic Valve Bypass for Aortic Stenosis in a Patient With Paroxysmal Nocturnal Hemoglobinuria

2010 ◽  
Vol 90 (1) ◽  
pp. 279-281 ◽  
Author(s):  
Mehrdad Ghoreishi ◽  
Maria R. Baer ◽  
Ranjana Bhargava ◽  
Craig E. Stauffer ◽  
Bartley P. Griffith ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Aortic Valve Bypass

Abstract 381: Clinical Outcomes Following Transcatheter Aortic Valve Replacement Among US Hospitals

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Fenton McCarthy ◽  
Katherine M McDermott ◽  
Vinay Kini ◽  
Dale Kobrin ◽  
Nimesh D Desai ◽  
...  
Keyword(s):  
Clinical Trials ◽  
High Risk ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Clinical Outcomes ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Mortality Rates ◽  
Transcatheter Aortic Valve ◽  
Cardiovascular Interventions

Background: Transcatheter Aortic Valve Replacement (TAVR) demonstrated excellent outcomes in clinical trials of inoperable/high-risk patients. Subsequent approval by the Food and Drug Administration and National Coverage Determination by the Centers for Medicare and Medicaid Services established unique volume requirements for institutions and physicians to perform TAVR. Diffusion of prior cardiovascular interventions has involved less stringent policies and exhibited significant institutional variation in clinical outcomes. Our objective is to compare risk-standardized procedural outcomes across US hospitals performing TAVR to identify hospitals with outlying post-procedure mortality rates. Methods: All Medicare fee-for-service beneficiaries who underwent TAVR between January 1, 2011 and November 30, 2012 were identified. Thirty-day risk-standardized mortality rates (RSMR) were calculated using the Hospital Compare statistical method, a well-validated hierarchical generalized linear model. Results: Claims were examined from 5044 patients undergoing TAVR at 199 hospitals, with a crude 30-day mortality rate of 5.97%. RSMRs modeled using patient-level predictors varied from 4.5 % to 9.0 % (Figure 1). One hospital had a RSMR statistically lower than the national mean (4.5%, P<0.05), and two hospitals had RSMRs statistically higher than the national mean (8.5% and 6.9%, P<0.05). Conclusions: Clinical outcomes among TAVR hospitals in high-risk/inoperable patients demonstrated very little variability, few outliers, and excellent outcomes comparable to pre-approval clinical trials. This may be the result of the unique policy and regulatory environment governing the CMS coverage determination for TAVR institutions. As TAVR disseminates to additional hospitals and other new cardiovascular interventions are inevitably introduced, risk-standardized outcome comparisons across hospitals may facilitate ongoing surveillance to ensure high quality outcomes at all active centers.

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