Related Experiment Video
Updated: Dec 12, 2025
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Impact of Operator Characteristics on Outcomes in Transcatheter Aortic Valve Replacement
Lisa Q Rong1, Mario Gaudino2, Derrick Y Tam3
1Department of Anesthesiology, Weill Cornell Medicine, New York, New York.
Background:
Operator characteristics and outcome relationships have not been evaluated at the individual operator level.
Methods:
From New York State Department of Health Statewide Planning and Research Cooperative System, 5896 elective transfemoral transcatheter aortic valve replacement (TAVR) procedures performed by 161 operators between 2012 and 2016 were analyzed. We examined the following characteristics of the primary operator: specialty (surgery vs cardiology), sex, medical school location, experience of cardiology practice, interventional cardiology credentialing, past-year TAVR volume, and first year performing TAVR in New York State. The primary outcome was a composite of inhospital mortality, stroke, and acute myocardial infarction.
Results:
After adjusting for patient and other provider characteristics, there was no significant difference in the risk of major events between surgeons and cardiologists in performing TAVR (3.4% vs 3.6%, P = .60), between male operators and female operators (P = .80), and between operators who graduated from a US medical school and operators educated outside the United States (3.4% vs 3.6%, P = .73). In the subgroup analysis, interventional cardiology credentialing was not significantly associated with the inhospital major events (odds ratio 1.03; 95% confidence interval, 0.56 to 1.88; P = .80).
Conclusions:
Primary operator specialty and other characteristics for TAVR were not associated with a difference in risk-adjusted inhospital outcomes. That may be due to the heart team model that allows proceduralists of different backgrounds to lend their expertise to the procedure.
