A new sub-study from the CoreValve U.S. Trial published in February's issue of JACC: Cardiovascular Interventions marks a step closer to a model for deciding what extreme surgical risk patients should NOT undergo Transcatheter Aortic Valve Replacement (TAVR).

While a majority of extreme-risk patients did see significant positive change in disease-specific, general health and quality-of-life metrics following TAVR, a large minority—39 percent of patients—had a poor outcome post-TAVR.

Several extreme surgical risk factors independently associated with poor outcomes from TAVR were known prior to the sub-study, such as wheelchair or oxygen dependency and an STS mortality risk above 15 percent. But the sub-study found two more previously unidentified risk factors—prior Coronary Artery Bypass Grafting and low Albumin (< 3.3g/dl)—which offer a more complete picture for a potential selection model for TAVR in extreme-risk patients.

The authors suggest that further work is necessary to create such a model. This could present an interesting and valuable research opportunity for any of our members working with TAVR.

Sarah Maret, MSN, NP-C, will be discussing TAVR at ACVP's upcoming Cleveland Cardio Conference on March 7 sponsored by Cleveland Clinic. Don't forget to grab those CEUs and network with cardiovascular professionals in Ohio!