Abstract 13656: Who is Being Referred for TAVR?: Patterns of Referral for TAVR at a Single Academic Medical Center
Introduction: Limited data exists regarding the patients being referred for evaluation for transaortic valve replacement (TAVR) for symptomatic aortic valve stenosis; including referral patterns and treatment. We describe a single-center experience of patients referred for evaluation for TAVR.
Methods: Patients with ICD-9 diagnosis codes for aortic stenosis (AS) seen at Duke University Medical Center between December 2010 and December 2011 were identified. Detailed review of these patients was performed to identify those specifically evaluated to consider TAVR. Patient demographics, referral patterns, and treatments were cataloged.
Results: A total of 1586 unique patients were identified as having been seen at Duke between 12/10 and 12/11 for AS. Of those, 239 were evaluated for TAVR. Half were female (120 (50%)), average age was 79.9 years (10.1), and 26 (12%) were non-white. The majority of patients seen in evaluation for TAVR were new to the Duke Health system (151 (63%)), presented as outpatients (191 (80%)), and were referred to cardiology (158(66%)). Figure 1a lists the treatments received; 46 patients (19%) underwent TAVR and 72 (30%) open surgical AVR. Figure 1b displays the reasons why patients did not receive TAVR, with insufficient surgical risk being the most common
Conclusions: This single-center TAVR program data shows that the majority of these elderly patients with symptomatic aortic valve stenosis were initially evaluated in an outpatient setting, and most were new to the Duke Health system. These data also demonstrate that a minority of patients seen for evaluation of TAVR are so treated, although half of these elderly, high risk individuals received valve replacement. These data support the development of a multidisciplinary program in centers for the evaluation and treatment of aortic valve stenosis.
- © 2012 by American Heart Association, Inc.