The Beat Goes On: Game-Changing Procedures in TVT! - 2025 Quality Summit Presentation (Non-CE)-The Beat Goes On: Game-Changing Procedures in TVT!

Video Transcription

Video Summary

Dr. Tarani, chair of the TVT registry and the Bernie Marcus Heart Valve Institute, delivered an extensive overview of transcatheter valve therapies (TVT) data and future directions, emphasizing the registry’s critical role since its inception in 2008. The TVT Registry now includes data from 850 U.S. sites with over 106,000 TAVR procedures performed in 2024 alone. Most TAVR patients remain elderly (>65 years), predominantly Caucasian, with a roughly equal risk distribution (low, intermediate, high). Common procedural aspects include 96% transfemoral access, a 7-10% pacemaker rate, and stable stroke and bleeding rates, although bleeding complications may be underreported. One-year mortality remains a concern, doubling from discharge rates, highlighting the need for improved post-procedural care.<br /><br />Mitral and tricuspid transcatheter interventions, though less common, are growing rapidly. About 16,000 mitral procedures occur annually, with functional mitral regurgitation cases increasing. Residual mitral gradients above 10 mmHg, rather than 5, are considered more clinically relevant. Mortality rates for mitral valve interventions remain higher than for aortic, partly due to complex redo and calcium-laden cases.<br /><br />Tricuspid valve therapies are the newest and fastest expanding area, with increasing use of replacement and repair devices such as the Evoque valve. These procedures exhibit low mortality and stroke rates but require diligent data collection to optimize patient selection and outcomes.<br /><br />Emerging technologies include dedicated valves for aortic regurgitation (e.g., Jena valve), novel low-profile TAVR devices (e.g., Myers valve), and evolving mitral and tricuspid replacements with improved procedural techniques aiming for minimal anesthesia and short hospital stays.<br /><br />Dr. Tarani underscored the importance of the TVT registry for continuous quality improvement, transparency, and innovation in valve therapies. He emphasized challenges like data collection burdens and the need for long-term outcome tracking beyond 30 days. The future of valve therapies relies on collaborative efforts and rigorous data-driven evaluation to ensure optimal patient care and cost-effectiveness amidst evolving CMS reimbursement policies and outpatient procedure considerations.

Keywords

intravascular imaging

percutaneous coronary intervention

IVUS

OCT

cardiovascular care

plaque assessment

stent placement

non-invasive imaging

cardiac interventions

Transcatheter Valve Therapies

TVT Registry

TAVR Procedures

Mitral Valve Interventions

Tricuspid Valve Therapies

Aortic Regurgitation Valves

Pacemaker Rates

Post-Procedural Mortality

Valve Replacement Devices

Data-Driven Quality Improvement