TAVR adoption and outcomes in German national practice

The advent of transcatheter aortic valve replacement (TAVR) has afforded an alternative to surgical aortic valve replacement (SAVR) for high-risk or non-operative candidates for aortic valve surgery. However, the adoption of TAVR may not be limited to the patient population for who the procedure has studied and outcomes in routine clinical practice may not reflect those of prior randomized trials. In this retrospective study including data on all TAVR and SAVR procedures in Germany from 2007 to 2013, the authors examine the use of these procedures in clinical practice and associated patient outcomes. A total of 32,581 TAVI and 55,992 SAVR (without concomitant revascularization) were performed during this period. Use of TAVR increased from 144 procedures in 2007 to 9147 in 2013, while the number of SAVRs decreased from 8622 to 7048 over the same period. Compared with patients receiving SAVR, patients receiving TAVR were older (81.0±6.1 years vs 70.2±10.0 …