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Related Experiment Video

Updated: Feb 8, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Evolving trends in aortic valve replacement: A statewide experience.

Karen M Kim1, Francis Shannon2, Gaetano Paone2

  • 1Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.

Journal of Cardiac Surgery
|June 19, 2018
PubMed
Summary
This summary is machine-generated.

Transcatheter aortic valve replacement (TAVR) dramatically increased while surgical aortic valve replacement (SAVR) declined. This shift is driven by patients with lower predicted mortality risk now deemed higher risk by Heart Teams.

Keywords:
TAVITAVRaortic valve replacementdatabase

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Health Services Research

Background:

  • Transcatheter aortic valve replacement (TAVR) offers an alternative to surgical aortic valve replacement (SAVR) for patients with intermediate, high, or extreme mortality risk from SAVR.
  • This study examines recent trends in aortic valve replacement (AVR) procedures within Michigan.

Purpose of the Study:

  • To analyze the trends in SAVR and TAVR volumes and patient risk stratification in Michigan from 2012 to 2017.
  • To understand the evolving patient profiles undergoing TAVR compared to SAVR.

Main Methods:

  • Utilized the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC) database for case numbers (January 2012–June 2017).
  • Categorized patients into risk groups (low, intermediate, high, extreme) based on STS predicted risk of mortality (PROM).
  • Matched TAVR patients with the Transcatheter Valve Therapy Registry to assess Heart Team risk designations.

Main Results:

  • Total annual AVR volume increased by 40.0%, from 2086 to 2920 cases.
  • SAVR cases decreased by 13.3% (1892 to 1640), while TAVR cases surged by 560% (194 to 1280).
  • Over 70% of TAVR patients had PROM ≤8% but were often designated high/extreme risk by Heart Teams, unlike SAVR patients (>90% with PROM ≤8%).

Conclusions:

  • SAVR volume showed a gradual decline, whereas TAVR volume experienced a dramatic increase during the study period.
  • The rise in TAVR is partly attributed to patients with lower STS PROM scores being classified as higher risk due to factors beyond the PROM score.
  • This suggests a nuanced approach to risk assessment and procedural selection in aortic valve replacement.