Welcome to the STS-ACC TVT Registry April Case Scenario for Version 3. This month we will cover Sequence 9002, Intra and Post-Procedure Events Occurred, Vascular Complication Minor. A 74-year-old male presented for TAVR. Right femoral valve delivery site received per-close closure device, however, sutures were suboptimal. Manual pressure applied achieving hemostasis. No evidence of extravasation, oozing, or hematoma. How would Sequence 9002, Intra-Post-Procedure Events Occurred, be coded for vascular complication minor? No or Yes. Please take a moment to review the documentation in the question prior to making a final selection. And the answer is number one, No. Sequence 9002, Intra-Post-Procedure Events Occurred, would be coded as No for vascular complication minor. Per the data definition, there is no indication of an access site or access-related vascular injury, dissection, stenosis, perforation, rupture, arteriovenous fistula, pseudoaneurysms, hematomas, percutaneous closure device failure, not leading to death, life-threatening or major bleeding, visceral ischemia, or neurological impairment. Nor was there distal embolization treated with embolectomy and or thrombectomy and not resulting in amputation or irreversible end organ damage. Nor was there an unplanned endovascular stenting or unplanned surgical intervention not meeting the criteria for a major vascular complication. And lastly, there was no vascular repair or the need for vascular repair via surgery, ultrasound-guided compression, transcatheter embolization, or stent graft. Within the data dictionary, Sequence 9002, Intra-Post-Procedure Events Occurred, cites the updated standardized endpoint definitions for transcatheter aortic valve implantation published in 2012, which is where these definitions are pulled from. In Table 7, percutaneous closure device failure is defined as failure of a closure device to achieve hemostasis at the arteriotomy site leading to an alternative treatment other than manual compression or adjunctive endovascular ballooning. Using manual pressure is not considered an alternate treatment, therefore the definition is not met. Thank you for viewing the April 2021 STS-ACC TVT Registry Case Scenario. We'll see you next month.

Sequence 9002

Intra-Post-Procedure Events Occurred

TAVR

per-close closure device

minor vascular complication