Valvular & structural heart disease
Contemporary Operator Procedural Volumes and Outcomes for Transcatheter Aortic Valve Replacement (TAVR) and Mitral Transcatheter Edge-to-edge Repair (MTEER) in the US
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
Methodological detailsnational registry (Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapies (TVT) Registry), 2-level random-effects logistic regression
- National registry (STS/ACC TVT Registry)
- 2-level random-effects logistic regression
Main finding
As reported in the abstract
Odds ratio (95% CI)P value
Low-volume TAVR operatorsvs High-volume TAVR operators30-day mortality, adjusted
1.13(1.02–1.26)
P = 0.02Low-volume TAVR operatorsvs High-volume TAVR operatorsin-hospital complications, adjusted
1.09(1.03–1.16)
P = 0.005Low-volume MTEER operatorsvs High-volume MTEER operatorsin-hospital complications
1.31(1.11–1.56)
P = 0.002Low-volume MTEER operatorsvs High-volume MTEER operators30-day mortality, not different
1.16(0.96–1.41)
P = 0.12Observational 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.
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