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Published online: 2021-06-02
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Temporal trends of transcatheter aortic valve implantation in high-volume academic center over 10 years

Zenon Huczek, Bartosz Rymuza, Maciej Mazurek, Radosław Wilimski, Piotr Scisło, Karol Zbroński, Kajetan Grodecki, Szymon Jędrzejczyk, Ewa Pędzich-Placha, Piotr Hendzel, Krzysztof J Filipiak, Grzegorz Opolski, Janusz Kochman
DOI: 10.33963/KP.a2021.0030
·
Pubmed: 34076883

open access

Online first
Original article
Published online: 2021-06-02

Abstract

Background: Indications for transcatheter aortic valve implantation (TAVI) have gradually expanded since its introduction. Aim: The aim was to analyze temporal trends in TAVI characteristics based on experience of high-volume academic center over the period of 10 years. Methods: Five hundred and six consecutive (n = 506) patients with 1-year follow-up were divided into early (G1, years 2010–2013, n = 130), intermediate (G2, 2014–2016, n = 164) and recent (G3, 2017–2019, n = 212) experience groups. Results: Patient’s age remained constant over time (mean [SD]; G1 = 79.1 [7.1] years vs G2 = 79.1 [7.1] years vs G3 = 79.7 [6.6] years, P = 0.73) but surgical risk in G3 was lower (log Euroscore, median [IQR]: G1 = 14.0 [8.4–20.2] vs G2 = 12.0 [7.0–22.2] vs G3 = 5.1 [3.5–8.5], P < 0.001). Major/life-threatening bleeding (G1 = 26.9% vs G2 = 12.8% vs G3 = 9.4%; P < 0.001), major vascular complications (G1 = 15.4% vs G2 = 8.5% vs G3 = 5.7%; P = 0.02) and moderate/severe paravalvular leak (G1 = 16.2% vs G2 = 11% vs G3 = 7.5%; P = 0.046) were decreasing with time. There was a significant drop in all-cause 1-year mortality in G3 (G1 = 20% vs G2 = 17.7% vs G3 = 9.1%; log rank = 0.01). Conclusion: Age of TAVI recipients remained unchanged over the last decade. Decreasing surgical risk coupled with improvements in procedural technique and care resulted in fewer periprocedural complications and better 1-year survival.

Abstract

Background: Indications for transcatheter aortic valve implantation (TAVI) have gradually expanded since its introduction. Aim: The aim was to analyze temporal trends in TAVI characteristics based on experience of high-volume academic center over the period of 10 years. Methods: Five hundred and six consecutive (n = 506) patients with 1-year follow-up were divided into early (G1, years 2010–2013, n = 130), intermediate (G2, 2014–2016, n = 164) and recent (G3, 2017–2019, n = 212) experience groups. Results: Patient’s age remained constant over time (mean [SD]; G1 = 79.1 [7.1] years vs G2 = 79.1 [7.1] years vs G3 = 79.7 [6.6] years, P = 0.73) but surgical risk in G3 was lower (log Euroscore, median [IQR]: G1 = 14.0 [8.4–20.2] vs G2 = 12.0 [7.0–22.2] vs G3 = 5.1 [3.5–8.5], P < 0.001). Major/life-threatening bleeding (G1 = 26.9% vs G2 = 12.8% vs G3 = 9.4%; P < 0.001), major vascular complications (G1 = 15.4% vs G2 = 8.5% vs G3 = 5.7%; P = 0.02) and moderate/severe paravalvular leak (G1 = 16.2% vs G2 = 11% vs G3 = 7.5%; P = 0.046) were decreasing with time. There was a significant drop in all-cause 1-year mortality in G3 (G1 = 20% vs G2 = 17.7% vs G3 = 9.1%; log rank = 0.01). Conclusion: Age of TAVI recipients remained unchanged over the last decade. Decreasing surgical risk coupled with improvements in procedural technique and care resulted in fewer periprocedural complications and better 1-year survival.

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Keywords

TAVI, low risk population, 1 year mortality, stroke, bleeding complications

About this article
Title

Temporal trends of transcatheter aortic valve implantation in high-volume academic center over 10 years

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-06-02

DOI

10.33963/KP.a2021.0030

Pubmed

34076883

Keywords

TAVI
low risk population
1 year mortality
stroke
bleeding complications

Authors

Zenon Huczek
Bartosz Rymuza
Maciej Mazurek
Radosław Wilimski
Piotr Scisło
Karol Zbroński
Kajetan Grodecki
Szymon Jędrzejczyk
Ewa Pędzich-Placha
Piotr Hendzel
Krzysztof J Filipiak
Grzegorz Opolski
Janusz Kochman

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