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Arch Cardiovasc Dis. 2016 Aug-Sep;109(8-9):457-64. doi: 10.1016/j.acvd.2016.01.016. Epub 2016 Jun 21.

Trends over the past 4 years in population characteristics, 30-day outcomes and 1-year survival in patients treated with transcatheter aortic valve implantation.

Author information

1
Centre Hospitalier Universitaire Charles-Nicolle, Université de Rouen, Inserm U1096, Rouen, France.
2
Centre Hospitalier Universitaire Charles-Nicolle, Université de Rouen, Inserm U1096, Rouen, France. Electronic address: eric.durand@chu-rouen.fr.

Abstract

BACKGROUND:

Transcatheter aortic valve implantation (TAVI) is recommended in patients with severe aortic stenosis that is either inoperable or at high-risk for surgical valve replacement.

AIMS:

To evaluate trends in the feasibility and safety of transfemoral TAVI over the past 4 years.

METHODS:

Between 2010 and 2013, all consecutive patients undergoing TAVI in our institution were included in a prospective registry. Population characteristics and 30-day and 1-year outcomes were analysed. Outcomes were classified according to the Valve Academic Research Consortium-2.

RESULTS:

Overall, 429 patients underwent TAVI; transfemoral access was used in 368 (85.7%). The proportion of patients treated via a transfemoral approach increased (70.1% to 89.9%; P<0.0001) and the use of prior balloon aortic valvuloplasty decreased (44.7% to 11.2%; P<0.0001). The mean logistic EuroSCORE decreased significantly from 19.4±10.9% to 15.8±8.7% (P=0.01). The 30-day mortality rate did not change significantly (6.4% vs. 5.6%; P=0.99). Similarly, rates of major vascular complications (12.8% vs. 15.4%; P=0.87) and stroke (2.1% vs. 1.4%; P=0.75) remained unchanged. Mean length of stay after TAVI decreased significantly from 8.9±11.3 days to 4.8±4.7 days (P=0.002) and 72 (50.3%) patients were discharged early in 2013. One-year survival increased significantly from 81.0% to 94.4% (P=0.03).

CONCLUSIONS:

Over the past 4 years, TAVI has been increasingly performed using a transfemoral approach. Treated patients are at lower-risk with less co-morbidity. Thirty-day mortality and complications remained unchanged, but length of stay after TAVI and 1-year mortality decreased dramatically.

KEYWORDS:

Aortic stenosis; Rétrécissement aortique; TAVI; VARC-2

PMID:
27342810
DOI:
10.1016/j.acvd.2016.01.016
[Indexed for MEDLINE]
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