Transcatheter mitral valve replacement (TMVR) is a catheter-based procedure in which a new valve is implanted in the mitral position. The Society of Thoracic Surgeons (STS) and American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry provides a national system for monitoring the safety and real-world outcomes of transcatheter valve procedures, including mitral valve replacement. Through standardized data collection and performance evaluation, the registry supports quality improvement and research in structural heart care. NCDR
For patients undergoing TMVR, the registry collects information about medical history, clinical status, procedural indications, and treatment outcomes. Its replacement-specific data distinguish native-valve, valve-in-valve, and valve-in-ring procedures. Additional information includes the access route, device selection, successful implantation, remaining mitral regurgitation, and the pressure gradient across the implanted valve. These details help characterize both the procedure performed and its immediate results.
Important complications monitored include bleeding, stroke, vascular injury, device migration or embolization, valve thrombosis, and the need for another mitral valve intervention. The registry also captures left ventricular outflow tract obstruction, an important safety outcome specific to mitral valve replacement, and follow-up imaging findings such as leakage through or around the replacement valve.
Follow-up data are collected at 30 days and one year to evaluate recovery beyond the initial hospitalization. Assessments include survival, functional status, echocardiographic findings, and patient-reported health status using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Together, these measures help evaluate valve performance and how patients feel and function after treatment.
By combining procedural results with follow-up outcomes, the TVT Registry helps participating programs compare performance, identify opportunities for improvement, and contribute to research and device surveillance. Its central purpose is to use clinical data to strengthen patient safety and improve the quality of transcatheter mitral valve replacement care.