Valvular & structural heart disease
Will a Conservative Case Selection Strategy Improve Hospital-Level Transcatheter Aortic Valve Replacement (TAVR) Performance Metrics?
Main finding · Hospital-level risk-adjusted win ratio (primary composite)Result — go to the resultMean difference 0.002Authors' conclusion
Hospital-level, risk-adjusted TAVR outcomes did not consistently improve with simulated strategies of avoiding the highest-risk cases.
Study context
- Population
- Adults (≥18 years) undergoing TAVR in the STS/ACC Transcatheter Valve Therapy registry in 202143,907 cases with primary outcome data
- Exposure
- After omission of top 10% highest-risk vs Before omission
- Outcome
- Composite of:
- Death
- Stroke
- VARC major/life-threatening/disabling bleeding
- Renal failure
- Moderate/severe para-valvular leak
- Follow-up
- 30 days
Methodological detailsmulticenter, simulation models based on registry data
- Multicenter
- Simulation models based on registry data
Main finding
As reported in the abstract
Hospital-level risk-adjusted win ratio (primary composite)
Mean difference
0.002
P = 0.60
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Mean difference | P value |
|---|---|---|
| 30-day death: hospital-level observed/expected ratio · 30 daysAfter omission vs Before omission · ±0.633 (SD) | −0.003 | P = 0.90 |
- 30-day death: hospital-level observed/expected ratio: 56 982 cases with secondary outcome data
Original publication
Will a Conservative Case Selection Strategy Improve Hospital-Level TAVR Performance Metrics? Circ Cardiovasc Interv. Published 4 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it