Valvular & structural heart diseaseCohort study

Contemporary Operator Procedural Volumes and Outcomes for Transcatheter Aortic Valve Replacement (TAVR) and Mitral Transcatheter Edge-to-edge Repair (MTEER) in the US

JAMA CardiolPublished

  • Retrospective cohort study
  • national registry (Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapies (TVT) Registry)
  • 2-level random-effects logistic regression

Authors' conclusion

In this cohort study, results from a large, contemporary US registry demonstrate a persistent inverse association between operator volume and patient outcomes for both TAVR and MTEER.

Study context

Population
Consecutive US patients undergoing TAVR for AS or MTEER for mitral regurgitation, 2020–2023TAVR 358,943
Exposure
Low-volume vs high-volume operators for TAVR and MTEER
Outcome
30-day all-cause mortality, 30-day composite outcome, and in-hospital procedural complications
Follow-up
30 days

Main finding

As reported in the abstract

Odds ratio (95% CI)P value
Low-volume TAVR operators vs High-volume TAVR operators30-day mortality, adjusted
1.13(1.02–1.26)
P = 0.02
Low-volume TAVR operators vs High-volume TAVR operatorsin-hospital complications, adjusted
1.09(1.03–1.16)
P = 0.005
Low-volume MTEER operators vs High-volume MTEER operatorsin-hospital complications
1.31(1.11–1.56)
P = 0.002
Low-volume MTEER operators vs High-volume MTEER operators30-day mortality, not different
1.16(0.96–1.41)
P = 0.12

Observational data: associations, not effects.

Further findings

Process of care measures

Inferior in low-volume vs high-volume operators

Consistency across hospital volume strata

Associations consistent across hospital volume strata

Correlation of operator-level TAVR and MTEER outcomes

Not correlated

Original publication

Contemporary Operator Procedural Volumes and Outcomes for TAVR and MTEER in the US. JAMA Cardiol. Published 1 March 2026. doi:10.1001/jamacardio.2025.5645

Summarised from the published abstract; every number is checked against it