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Eight-years trends and outcomes in TAVI performed in a high-volume center
Journal article

Eight-years trends and outcomes in TAVI performed in a high-volume center

  • Tagliari, A University Hospital Zurich, Zurich, Switzerland
  • Haager, P.K Kantonhospital, Cardiology, St Gallen, Switzerland
  • Miura, M University Hospital Zurich, Zurich, Switzerland
  • Russo, G University Hospital Zurich, Zurich, Switzerland
  • Pozzoli, A University Hospital Zurich, Zurich, Switzerland
  • Gavazzoni, M University Hospital Zurich, Zurich, Switzerland
  • Zuber, M University Hospital Zurich, Zurich, Switzerland
  • Joerg, L Kantonhospital, Cardiology, St Gallen, Switzerland
  • Maisano, F University Hospital Zurich, Zurich, Switzerland
  • Taramasso, M University Hospital Zurich, Zurich, Switzerland
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  • 2020-11-25
Published in:
  • European Heart Journal. - Oxford University Press (OUP). - 2020, vol. 41, no. Supplement_2
Cardiology and Cardiovascular Medicine
English Abstract

Introduction
Since the first transcatheter aortic valve implantation (TAVI), remarkable changes in procedure features and patients' profile have been reported, making it a widespread treatment for severe aortic stenosis in all risk-class patients.


Purpose
To evaluate TAVI contemporary trends and outcomes in the last 8 years in a high-volume TAVI center.


Methods
Data of adult patients submitted to TAVI from April 2012 to April 2019 in a high-volume center were obtained from the Swiss TAVI registry, a prospective national multi-center database. Patients were divided according to implant period in two groups: 1) TAVI performed from 2012 to 2016, and 2) TAVI performed from 2017 to 2019.


Results
Over a 8-years period, a total of 1485 procedures were performed, increasing from 95 in 2012 to 320 in 2018 (p<0.001). A remarkable modification in patients' profile and procedure characteristics can be seen in Table 1. Despite higher age and surgical risk, a significant decrease in 1-year mortality (6.8% vs. 3.2%; p<0.001) was observed in the last 3 years. This difference was especially notable in the subgroup of high-risk patients (STS score ≥8), who presented a decrease in 30-days (5% vs. 3.3%; p=0.001) and 1-year mortality (13.1% vs. 4.9%; p<0.001). In multivariate analysis, age (OR 1.05, 95% CI: 1.0–1.1), non-femoral access (OR 2.7, 95% CI: 1.2–6.0), and STS score (OR 1.07, 95% CI: 1.0–1.1) were independent predictors of in-hospital mortality, while male gender (OR 1.8, 95% CI: 1.0–3.2), chronic obstructive pulmonary disease (OR 2.1, 95% CI: 1.1–3.9), and STS score (OR 1.07, 95% CI: 1.01–1.14) were predictors of 1-year mortality.


Conclusion
Significant changes in patients' profile and procedure characteristics were observed in the last 3 years of TAVI experience. Even performed in elderly and high-risk patients, TAVI was associated with low early and 1-year mortality. The Swiss TAVI registry offers a unique opportunity to monitor trends and outcomes in patient submitted to TAVI.


Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): APT is a Ph.D. study and her scientific research is supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (Capes) - Finance Code 001.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/199164
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