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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Candidates for transcatheter aortic valve replacement: fitting the PARTNERS criteria

Michael J Babcock1, Steven Lavine, Joel A Strom

  • 1Department of Medicine, Division of Cardiovascular Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 18, 2012
PubMed

Insights

Identifying patients for Transcatheter Aortic Valve Replacement (TAVR) is challenging. A minimum of 150-170 severe aortic stenosis (AS) patients are needed annually to support a TAVR program.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Heart Valve Disease

Background:

  • Severe aortic stenosis (AS) prevalence is known, but identifying candidates for Transcatheter Aortic Valve Replacement (TAVR) is less established.
  • Understanding the TAVR candidate population is crucial for developing new TAVR programs.
  • Professional societies suggest a minimum of 20-24 annual cases to sustain a TAVR program.

Purpose of the Study:

  • To estimate the annual patient volume meeting PARTNER-B criteria for TAVR.
  • To provide insights into the necessary patient volume for TAVR program sustainability.

Main Methods:

  • Screened 21,652 patients from a single-center echocardiography registry over 3 years.
  • Identified 833 patients with AS, stratified by severity.
  • Assessed nonsurgical candidates against PARTNER-B exclusion criteria for TAVR eligibility.

Main Results:

  • 133 patients (16%) had symptomatic AS; 50 (38%) were nonsurgical candidates.
  • Nonsurgical candidates had significantly higher STS scores (11.1 ± 10.8 vs. 4.0 ± 3.3, P < 0.001).
  • Only 18 patients (14%) met PARTNER-B criteria for TAVR, indicating a need for 150-170 symptomatic severe AS patients for 20-24 annual TAVR cases.

Conclusions:

  • The prevalence of patients meeting PARTNER-B criteria for TAVR can be low in real-world practice.
  • High-volume or regional referral centers may be necessary strategies for TAVR program implementation.
  • Optimizing patient selection and referral pathways is essential for TAVR program success.
Abstract

Keywords:
aortic stenosistranscatheter aortic valve replacement

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