Scholars@Duke
Pratik Manandhar

Pratik Manandhar

Biostatistician III
Duke Clinical Research Institute
pratik.manandhar@duke.edu
200 Morris St, Location # 4500-D, Durham, NC 27701
200 Morris St, Location #4500-D, Durham, NC 27701

Scholarly Works

Sex and Racial Disparities in Outcomes of Transcatheter Edge-to-Edge Mitral Valve Repair for Functional Mitral Regurgitation: A Multicenter Prospective Analysis.

Journal article Struct Heart · May 2026 BACKGROUND: Functional mitral regurgitation (FMR) is associated with poor heart failure (HF) outcomes. Mitral transcatheter edge-to-edge repair (M-TEER) is recommended for symptomatic patients despite medical therapy, though the influence of sex and race o ... Full text Link to item Cite

Contemporary Operator Procedural Volumes and Outcomes for TAVR and MTEER in the US.

Journal article JAMA Cardiol · March 1, 2026 IMPORTANCE: Recent evidence suggests that hospital-level associations between procedural volume and outcomes for transcatheter aortic valve replacement (TAVR) and mitral transcatheter edge-to-edge repair (MTEER) may be plateauing. Less is known about the o ... Full text Link to item Cite

Radial vs femoral access for percutaneous coronary intervention: temporal trends and outcomes in the USA.

Journal article Eur Heart J · February 9, 2026 BACKGROUND AND AIMS: Radial access site for percutaneous coronary intervention (PCI) is recommended by clinical practice guidelines because of superior outcomes compared with femoral access site. Historically, the adoption of radial access site in the USA ... Full text Link to item Cite

Prediction of Heart Failure Hospitalization or Death After TAVR.

Journal article Circ Cardiovasc Interv · February 2026 BACKGROUND: Heart failure (HF) remains a significant burden following transcatheter aortic valve replacement, adversely impacting survival and quality of life. Identification of patients who may benefit from closer monitoring or adjunctive medical therapy ... Full text Link to item Cite

Will a Conservative Case Selection Strategy Improve Hospital-Level TAVR Performance Metrics?

Journal article Circ Cardiovasc Interv · January 2026 BACKGROUND: Current national performance metrics rank transcatheter aortic valve replacement (TAVR) centers based on risk-adjusted outcomes. This could make operators/centers less inclined to offer TAVR in high-risk cases. METHODS: We used simulation model ... Full text Link to item Cite

Outcomes of Transcatheter Aortic Valve Replacement in Low-Risk Patients in the United States: A Report From the STS/ACC TVT Registry.

Journal article Circulation · April 22, 2025 BACKGROUND: Real-world low-risk transcatheter aortic valve replacement (TAVR) outcomes in the United States have not been assessed comprehensively versus pivotal trials, which is a key component of measuring the quality of clinical technology adoption. MET ... Full text Link to item Cite

Trends in Transcatheter Aortic Valve Replacement Outcomes: Insights From the STS/ACC TVT Registry.

Journal article JAMA Cardiol · December 1, 2024 IMPORTANCE: Although transcatheter aortic valve replacement (TAVR) outcomes in the US have improved substantially since 2011, it is unknown whether these trends have continued since 2019. OBJECTIVE: To examine changes in risk-adjusted TAVR outcomes from 20 ... Full text Link to item Cite

Opioid Treatment Is Associated with Recurrent Healthcare Visits, Increased Side Effects, and Pain.

Journal article West J Emerg Med · November 2024 INTRODUCTION: Pain is a major driver of visits to the emergency department (ED). Clinicians must consider not only the efficacy of treatment options but also subsequent healthcare utilization and patient-centered outcomes such as side effects from prescrib ... Full text Link to item Cite

Failure to Rescue After Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry.

Journal article Circulation. Cardiovascular interventions · August 2024 BackgroundFailure to rescue (FTR) describes in-hospital mortality following a procedural complication and has been adopted as a quality metric in multiple specialties. However, FTR has not been studied for percutaneous coronary intervention (PCI) ... Full text Cite

Impact of Elevated Gradients After Transcatheter Aortic Valve Implantation for Degenerated Surgical Aortic Valve Bioprostheses.

Journal article Circ Cardiovasc Interv · July 2024 BACKGROUND: Elevated aortic valve gradients are common after transcatheter aortic valve implantation for degenerated surgical aortic valve replacement bioprostheses, but their clinical impact is uncertain. METHODS: A total of 12 122 patients who underwent ... Full text Link to item Cite

Association between characteristics of employing healthcare facilities and healthcare worker infection rates and psychosocial experiences during the COVID-19 pandemic.

Journal article BMC Health Serv Res · May 24, 2024 BACKGROUND: Healthcare facility characteristics, such as ownership, size, and location, have been associated with patient outcomes. However, it is not known whether the outcomes of healthcare workers are associated with the characteristics of their employi ... Full text Link to item Cite

Comparison of Transcatheter Edge-to-Edge Mitral Valve Repair for Primary Mitral Regurgitation Outcomes to Hospital Volumes of Surgical Mitral Valve Repair.

Journal article Circ Cardiovasc Interv · April 2024 BACKGROUND: Transcatheter edge-to-edge mitral valve (MV) repair (TEER) is an effective treatment for patients with primary mitral regurgitation at prohibitive risk for surgical MV repair (MVr). High-volume MVr centers and high-volume TEER centers have bett ... Full text Link to item Cite

National Variation in Hospital MTEER Outcomes and Correlation With TAVR Outcomes: STS/ACC TVT Registry Analysis.

Journal article JACC Cardiovasc Interv · February 26, 2024 BACKGROUND: A single, multitiered valve center designation has been proposed to publicly identify centers with expertise for all valve therapies. The correlation between transcatheter aortic valve replacement (TAVR) and mitral transcatheter edge-to-edge re ... Full text Link to item Cite

National Variability in Pacemaker Implantation Rate Following TAVR: Insights From the STS/ACC TVT Registry.

Journal article JACC Cardiovasc Interv · February 12, 2024 BACKGROUND: Although permanent pacemaker (PPM) implantation is a common complication of transcatheter aortic valve replacement (TAVR), hospital variation and change in PPM implantation rates are ill defined. OBJECTIVES: The aim of this study was to determi ... Full text Link to item Cite

Outcomes of Transcatheter Aortic Valve Replacement in Asymptomatic or Minimally Symptomatic Aortic Stenosis.

Journal article JACC Cardiovasc Interv · November 13, 2023 BACKGROUND: Little is known about the outcomes of transcatheter aortic valve replacement (TAVR) in minimally symptomatic patients. OBJECTIVES: The authors aimed to evaluate the outcomes of patients with minimally symptomatic severe aortic stenosis treated ... Full text Link to item Cite

Mediators of Improvement in TAVR Outcomes Over Time: Insights From the STS-ACC TVT Registry.

Journal article Circ Cardiovasc Interv · July 2023 BACKGROUND: Over the past decade, there has been substantial improvement in outcomes after transcatheter aortic valve replacement. Many patient and procedural factors have also changed over that time, making it challenging to untangle the drivers of those ... Full text Link to item Cite

Outcomes and Institutional Variation in Arterial Access Among Patients With AMI and Cardiogenic Shock Undergoing PCI.

Journal article JACC Cardiovasc Interv · June 26, 2023 BACKGROUND: Contemporary data comparing the outcomes of transradial access (TRA) vs transfemoral access (TFA) among patients presenting with acute myocardial infarction and cardiogenic shock (AMI-CS) undergoing percutaneous coronary intervention (PCI) are ... Full text Link to item Cite

Association of Transcatheter Aortic Valve Replacement Reimbursement, New Technology Add-on Payment, and Procedure Volumes With Embolic Protection Device Use.

Journal article JAMA Cardiol · September 1, 2022 IMPORTANCE: In the setting of uncertain efficacy and additional, unreimbursed cost, use of an embolic protection device (EPD) during transcatheter aortic valve replacement (TAVR) has had variable uptake. The Centers for Medicare & Medicaid Services (CMS) i ... Full text Link to item Cite

Patient-reported vs. physician-estimated symptoms before and after transcatheter aortic valve replacement.

Journal article Eur Heart J Qual Care Clin Outcomes · March 2, 2022 AIMS: In contrast to patient-reported health status measures (such as the Kansas City Cardiomyopathy Questionnaire), the New York Heart Association class is based on a physician's assessment of heart failure symptoms and functional limitations on behalf of ... Full text Link to item Cite

Untapped Potential for Emergency Department Observation Unit Use: A National Hospital Ambulatory Medical Care Survey (NHAMCS) Study.

Journal article West J Emerg Med · January 18, 2022 INTRODUCTION: Millions of people present to the emergency department (ED) with chest pain annually. Accurate and timely risk stratification is important to identify potentially life-threatening conditions such as acute coronary syndrome (ACS). An ED-based ... Full text Open Access Link to item Cite

Transcatheter Mitral Valve Therapy in the United States: A Report from the STS/ACC TVT Registry.

Journal article Ann Thorac Surg · January 2022 Data for nearly all patients undergoing transcatheter edge-to-edge repair (TEER) and transcatheter mitral valve replacement (TMVR) with an approved device in the United States is captured in the Society of Thoracic Surgeons/American College of Cardiology T ... Full text Link to item Cite

Percutaneous Coronary Intervention Following Diagnostic Angiography by Noninterventional Versus Interventional Cardiologists: Insights From the CathPCI Registry.

Journal article Circ Cardiovasc Interv · January 2022 BACKGROUND: There are limited contemporary, national data describing diagnostic cardiac catheterization with subsequent percutaneous coronary intervention (ad hoc percutaneous coronary intervention [PCI]) performed by an invasive-diagnostic and interventio ... Full text Link to item Cite

Transcatheter Mitral Valve Therapy in the United States: A Report From the STS-ACC TVT Registry.

Journal article J Am Coll Cardiol · December 7, 2021 Data for nearly all patients undergoing transcatheter edge-to-edge repair (TEER) and transcatheter mitral valve replacement (TMVR) with an approved device in the United States is captured in the Society of Thoracic Surgeons/American College of Cardiology T ... Full text Link to item Cite

United States Emergency Department Use of Medications with Pharmacogenetic Recommendations.

Journal article West J Emerg Med · September 23, 2021 INTRODUCTION: Emergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient's specific genotype. How frequently ... Full text Open Access Link to item Cite

Composite Metric for Benchmarking Site Performance in Transcatheter Aortic Valve Replacement: Results From the STS/ACC TVT Registry.

Journal article Circulation · July 20, 2021 BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a transformative therapy for aortic stenosis. Despite rapid improvements in technology and techniques, serious complications remain relatively common and are not well described by single outcome ... Full text Link to item Cite

Higher daily pain severity after emergency department visits is associated with lower return-to-work rates.

Journal article The American journal of emergency medicine · July 2021 BackgroundPain can impair functional status, including a patient's ability to return to work. The purpose of this study was to determine whether there was an association between pain levels and return-to-work status during the first 4 days post-ED ... Full text Cite

Impact of short-term complications of transcatheter aortic valve replacement on longer-term outcomes: results from the STS/ACC Transcatheter Valve Therapy Registry.

Journal article Eur Heart J Qual Care Clin Outcomes · March 15, 2021 AIMS: While complications of transcatheter aortic valve replacement (TAVR) have decreased, they still occur commonly and may negatively impact both short- and long-term outcomes. We sought to examine the association of complications after TAVR with surviva ... Full text Link to item Cite

Practical Application of Patient-Reported Health Status Measures for Transcatheter Valve Therapies: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry.

Journal article Circ Cardiovasc Qual Outcomes · March 2021 BACKGROUND: Health status assessment is essential for documenting the benefit of transcatheter aortic valve replacement (TAVR) or transcatheter mitral valve repair on patients' symptoms, function, and quality of life. Health status can also be a powerful m ... Full text Link to item Cite

A Method for Grouping Emergency Department Visits by Severity and Complexity.

Journal article West J Emerg Med · August 21, 2020 INTRODUCTION: Triage functions to quickly prioritize care and sort patients by anticipated resource needs. Despite widespread use of the Emergency Severity Index (ESI), there is still no universal standard for emergency department (ED) triage. Thus, it can ... Full text Open Access Link to item Cite

Demographics, Procedural Characteristics, and Clinical Outcomes When Cardiogenic Shock Precedes TAVR in the United States.

Journal article JACC Cardiovasc Interv · June 8, 2020 OBJECTIVES: This paper details trends and outcomes in U.S. patients undergoing transcatheter aortic valve replacement (TAVR) who present pre-procedurally with cardiogenic shock. BACKGROUND: Demographic, procedural characteristics, and clinical outcomes in ... Full text Link to item Cite

Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement: Variation in Practice and Outcomes.

Journal article JACC Cardiovasc Interv · June 8, 2020 OBJECTIVES: The aims of this study were to examine variation in the use of conscious sedation (CS) for transcatheter aortic valve replacement (TAVR) across hospitals and over time and to evaluate outcomes of CS compared with general anesthesia (GA) using i ... Full text Link to item Cite

Transcatheter Aortic Valve Replacement After Prior Mitral Valve Surgery: Results From the Transcatheter Valve Therapy Registry.

Journal article Ann Thorac Surg · June 2020 BACKGROUND: Due to perceived technical challenges, patients with previous surgical mitral valve repair or replacement (SMVR) have been excluded from most transcatheter aortic valve replacement (TAVR) trials. Our objective was to compare the 30-day and 1-ye ... Full text Link to item Cite

Operator Experience and Outcomes of Transcatheter Mitral Valve Repair in the United States.

Journal article J Am Coll Cardiol · December 17, 2019 BACKGROUND: Transcatheter mitral valve repair (TMVr) for the treatment of mitral regurgitation (MR) is a complex procedure that requires development of a unique skillset. OBJECTIVES: The purpose of this study was to examine the relationship between operato ... Full text Link to item Cite

Incidence and Outcomes of Surgical Bailout During TAVR: Insights From the STS/ACC TVT Registry.

Journal article JACC. Cardiovascular interventions · September 2019 ObjectivesThe aim of this study was to evaluate the incidence and outcomes of surgical bailout during transcatheter aortic valve replacement (TAVR).BackgroundThe incidence and outcomes of unplanned conversion to open heart surgery, or "su ... Full text Cite

Association Between Transcatheter Aortic Valve Replacement and Early Postprocedural Stroke.

Journal article JAMA · June 18, 2019 IMPORTANCE: Reducing postprocedural stroke is important to improve the safety of transcatheter aortic valve replacement (TAVR). OBJECTIVE: This study evaluated the trends of stroke occurring within 30 days after the procedure during the first 5 years TAVR ... Full text Link to item Cite

Left Ventricular Hypertrophy Does Not Affect 1-Year Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement.

Journal article JACC Cardiovasc Interv · February 25, 2019 OBJECTIVES: The aim of this study was to evaluate the association between pre-procedural left ventricular hypertrophy (LVH) patterns and clinical outcomes after transcatheter aortic valve replacement (TAVR). BACKGROUND: The association between pre-procedur ... Full text Link to item Cite

Outcomes After Transcatheter Mitral Valve Repair in Patients With Renal Disease.

Journal article Circ Cardiovasc Interv · February 2019 BACKGROUND: Renal disease is associated with poor prognosis despite guideline-directed cardiovascular therapy, and outcomes by sex in this population remain uncertain. METHODS AND RESULTS: Patients (n=5213) who underwent a MitraClip procedure in the Nation ... Full text Link to item Cite

Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement.

Journal article JAMA · December 4, 2018 IMPORTANCE: Data are lacking on the effect of a renin-angiotensin system (RAS) inhibitor prescribed after transcatheter aortic valve replacement (TAVR). Treatment with a RAS inhibitor may reverse left ventricular remodeling and improve function. OBJECTIVE: ... Full text Link to item Cite

Peripheral Artery Disease and Transcatheter Aortic Valve Replacement Outcomes: A Report From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Therapy Registry.

Journal article Circ Cardiovasc Interv · October 2017 BACKGROUND: Peripheral artery disease (PAD) is associated with increased cardiovascular mortality, and PAD risk factors overlap with those for aortic stenosis. The prevalence and outcomes associated with PAD in a population undergoing transcatheter aortic ... Full text Link to item Cite

Hospital Practice of Direct-Home Discharge and 30-Day Readmission After Transcatheter Aortic Valve Replacement in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry.

Journal article J Am Heart Assoc · August 21, 2017 BACKGROUND: Nearly 17% of patients are readmitted within 30 days of discharge after transcatheter aortic valve replacement. Selected patients are discharged to skilled nursing facilities, yet the association between a hospital's practice to discharge home ... Full text Link to item Cite

Assessing Health Status of Khanigaun Village Development Committee in Nuwakot District of Nepal.

Journal article Journal of Nepal Health Research Council · January 2016 BackgroundAssessing health status is crucial to understand the level of health in the community. Maternal health, child health and behavioral practice on diseases are key issues to assess health status of a community in Nepal. Nationwide surveys a ... Cite