For TAVR, Home Is Where the Heart Is

Introduction

Transcatheter aortic valve replacement (TAVR) continues to rapidly expand across the United States, which has led to a wide range of centers with disparate procedural volumes and variable outcomes (1). As such, there is appropriate attention to maintaining quality and safety while providing adequate access to those who will benefit from treatment. Similar to percutaneous coronary intervention and cardiac surgery procedures, metrics are now being developed and reported for TAVR programs and operators. Because of the large number of TAVRs performed annually and the attendant costs, risk-adjusted, outcomes-based performance measures are critical in fairly comparing care quality across institutions. Mortality rates, stroke rates, and measures of quality of life have been suggested and used, but there is no consensus as to the most meaningful metrics for patients and health care professionals alike. In addition, these factors may not capture other outcomes that could be important in patient-centered decision-making, such as prolonged time in rehabilitation settings postprocedure.