Following a standardized protocol during transcatheter aortic valve replacement (TAVR) can significantly improve outcomes, according to the global Optimize PRO study published in JSCAI.
Key Findings:
- 600+ patients across 50 sites received Evolut PRO/PRO+ valves.
- Sites using a four-step cusp overlap technique (COT) checklist saw lower rates of permanent pacemaker implantation (PPMI)—6.4% vs. 18.5% when not followed.
- Standard protocol led to:
- 0.8% mortality and 1.7% disabling stroke at 30 days.
- 76% with no/trace aortic regurgitation.
- Median 2-day hospital stay, with many eligible for next-day discharge.
Technique Matters:
- Use of the Lunderquist guidewire halved PPMI rates (9% vs. 19%).
- Sites with full adherence to protocol saw more reproducible, superior outcomes.
Expert Insight:
Dr. Hemal Gada highlighted the simplicity and global adaptability of the protocol: “Having a homogeneous, simple procedure with just a few steps improves patient outcomes.”
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