STS/ACC TVT Registry
Society of Thoracic Surgeons / American College of Cardiology Transcatheter Valve Therapy Registry
Clinical Question
Population
All patients undergoing commercial TAVR at participating sites across the United States. Participation is mandated by CMS as a condition of reimbursement.
All FDA-approved transcatheter aortic valve replacement systems used in clinical practice
No control group; observational registry with internal benchmarking and temporal trend analysis
Primary Endpoint
Multiple: 30-day and 1-year mortality, stroke, vascular complications, pacemaker implantation, length of stay, quality metrics
Key Findings
In-hospital mortality decreased from 5.0% (2012) to under 1.5% (2022) as experience grew and technology improved.
30-day stroke rates declined from 2.0% to below 1.5% over the same period.
The proportion of low-risk patients increased from near zero before 2019 to over 40% of all TAVR cases by 2022.
Median hospital length of stay decreased from 6 days to 1-2 days with the adoption of minimalist approaches.
The registry identified centers with outlier outcomes and facilitated quality improvement interventions across the national TAVR program.
Impact on Clinical Practice
Guideline Impact
Limitations
As an observational registry, it cannot establish causality or control for confounding variables in the way randomized trials can.
Data completeness and accuracy depend on individual site reporting, with potential for missing or inconsistent data entry.
The registry captures procedural and short-term outcomes but long-term follow-up (beyond 1 year) is limited for most patients.
How Does This Trial Apply to Your Case?
Clinical trials inform guidelines, but every patient is unique. Our Heart Team evaluates how landmark evidence applies to your specific anatomy, risk profile, and preferences.
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