UNASSIGNED: We assessed the effect of a transcatheter aortic valve replacement (TAVR) program and Heart Team concept on our approach to severe isolated @entity472 ( @entity472 ) with regard to surgical practice, @entity1 selection, perioperative outcomes, 1-year survival, and AVR volume. TAVR program began in August 2011. @entity1 having isolated surgical AVR between January 2008 and August 2011, when the program began (n = 282, 42 months), were compared with those after the program began until February 2015 (n = 344, surgical AVR and n = 126, TAVR, 42 months). Isolated surgical AVR accounted for 21% of all valve procedures (isolated and concomitant) before and after the TAVR program. However, the volume of all isolated AVR (surgical and transcatheter) increased to 27% of all valve procedures (isolated and concomitant) after the TAVR program implementation. Mean Society Of Thoracic Surgeons (STS)-predicted mortality risk was similar among @entity1 who had surgical AVR pre-TAVR and post-TAVR implementation (2.3% vs 2.1%, P = 0.227), but addition of @entity1 who had TAVR (STS risk = 7.1%) increased STS-predicted risk for all isolated AVR (surgical and transcatheter) procedures (2.3% vs 3.4%, P < 0.001). A similar trend was found for age, including a slight decrease in octogenarians for surgical AVR post-TAVR (18% vs 13%, P = 0.084). Operative mortality for isolated surgical AVR was similar in pre-TAVR and post-TAVR (2.1% vs 1.8%, P = 0.798), as were observed/expected (O/E) ratios (0.91 vs 0.82). For all isolated AVR, O/E ratio was 0.91 pre-TAVR and 0.82 post-TAVR (n = 470), including O/E = 0.79 for @entity1 who had TAVR. No changes were found in proportion of isolated surgical AVR cases or @entity1 risk and outcomes after introduction of TAVR program and Heart Team. However, volume of @entity1 with severe @entity472 treated increased significantly post-TAVR. Our results reflect growing awareness of TAVR availability and accompanying increases in @entity1 referred to our Heart Team for @entity472 treatment.

The Effect of Initiation of a Transcatheter Aortic Valve Replacement Program in the Treatment of Severe XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity472 :: ('MESH:D001024', 'Disease') :: ['AS', 'symptomatic aortic stenosis']
@entity472 :: (MESH:D001024,Disease) :: ['Aortic Stenosis']
