A new study offers early validation of the recently released Valve Academic Research Consortium 3 (VARC-3) definition of technical success after transcatheter aortic valve replacement (TAVR), and highlights its role in patient prognosis.
Results show that one in 10 patients (11.6%) undergoing TAVR with contemporary devices and techniques experiences technical failure, according to VARC-3.
At 30 days, patients with technical failure had significantly higher rates of the composite of cardiovascular (CV) death or stroke (11.5% vs 3.5%), CV death (6.0% vs 1.0%), and stroke (7.2% vs 2.9%), compared with those with technical success.
Technical failure after TAVR was also independently associated with a twofold higher risk for CV death or stroke at 1 year (20.0% vs 10.3%; hazard ratio [HR], 2.01; 95% CI, 1.37 - 2.95).
Other independent predictors were history of peripheral artery disease (HR, 1.97), New York Heart Association III or IV disease (HR, 1.86), baseline moderate or greater mitral regurgitation (HR, 1.48), atrial fibrillation (HR, 1.40), and Society of Thoracic Surgeons predicted mortality risk (HR, 1.04).
"We were expecting that we were getting better over time with device iterations, with more experience, so we weren't surprised by the result. But I think what is somewhat surprising is how much of an impact it has on the outcome," senior study author Thomas Pilgrim, MD, Inselspital, University of Bern, Switzerland, told
