Temporal Trends in Transcatheter Aortic Valve Implantation, 2008-2014: Patient Characteristics, Procedural Issues, and Clinical Outcome

Overview

Journal Clin Cardiol

Specialty Cardiology & Vascular Diseases

Date 2016 Oct 27

PMID 27783882

Citations 13

Authors

Uri Landes

Alon Barsheshet

Ariel Finkelstein

Victor Guetta

Abid Assali

Amir Halkin

Hanna Vaknin-Assa

Amit Segev

Tamir Bental

Jeremy Ben-Shoshan

Israel M Barbash

Ran Kornowski

Affiliations

Soon will be listed here.

Abstract

Background: About a decade past the first transcatheter aortic valve implantation (TAVI), data are limited regarding temporal trends accompanying its evolution from novel technology to mainstream therapy. We evaluated these trends in a large multicenter TAVI registry.

Hypothesis: TAVI is changing and improving with time.

Methods: Patients who underwent TAVI between January 2008 and December 2014 at 3 high-volume Israeli centers were divided into 5 time quintiles according to procedure date. Outcomes were analyzed and reported according to Valve Academic Research Consortium-2.

Results: A total of 1285 patients were studied (43% male; mean age, 83 ± 3 years; mean Society of Thoracic Surgeons [STS] score, 5.5 ± 3.6). Over time, there was a shift toward treating patients at lower STS score, increased use of conscious sedation and transfemoral approach, and decreased use of balloon predilatation. The balloon-expandable to self-expandable valve utilization ratio decreased, the valve-in-valve experience increased from 4% to 17% of all TAVI volume, and length of hospital stay was halved (P = 0.006). Kaplan-Meier survival curves showed gradual decrease in mortality risk (P = 0.031), but there was no significant 1-year mortality decrease by multivariable analysis. Each year increment was associated with an adjusted 20%, 15%, and 12% decrease in new pacemaker obligation (P = 0.004), new pacemaker obligation or left bundle branch block (P = 0.008), and in-hospital infections (P = 0.082), respectively.

Conclusions: Temporal trends accompanying TAVI evolution include its utilization in lower-risk patients, procedural simplification, improved overall survival, decreased pacemaker obligation, and shorter hospital stay.

Citing Articles

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Disparities in Cardiovascular Prosthetic Device-Related Deaths: A Longitudinal Mortality Analysis in the United States.

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Whether monitored anesthesia care is the optimal anesthetic strategy for transcatheter aortic valve implantation surgery? a meta-analysis and systematic review.

Xie L, Lang Z, Liu Y, Yue H, Chen Q, Tao G BMC Anesthesiol. 2024; 24(1):429.

PMID: 39592928 PMC: 11600798. DOI: 10.1186/s12871-024-02834-w.

Temporal Trends in Patient Characteristics and Clinical Outcomes of TAVR: Over a Decade of Practice.

Karra N, Sharon A, Massalha E, Fefer P, Maor E, Guetta V J Clin Med. 2024; 13(17).

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Trend, demographics and outcomes of concurrent PCI with TAVR hospitalizations 2012-2018; an analysis from the National Inpatient Sample.

Patel H, Kumar A, Thakkar S, Victor V, Shariff M, Doshi R Indian Heart J. 2021; 73(6):760-762.

PMID: 34715122 PMC: 8642656. DOI: 10.1016/j.ihj.2021.10.009.

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