Current status of transcatheter valve therapy in Europe: results from an EAPCI survey

Our aim was to identify current discrepancies among European countries, and provide a basis for a general agreement on decision making specifically related to TAVI procedures. The European Association of Percutaneous
Coronary Interventions (EAPCI) therefore assessed the current status of transcatheter valve therapy (TAVI) in Europe through a web-based survey.

Three hundred and one European centres responded to the survey (61.4% of the invited centres). Fewer than 200 TAVI procedures per site had been performed up to the date of response in 47% of centres, while over 500 procedures had been performed in 21% of centres. The Heart Team consisted mostly of interventional cardiologists and cardiac surgeons. In 79% of the centres, specific TAVI protocols are in place. Of note, 45% of centres perform TAVI in intermediate-risk patients, while only 10% do so in low-risk patients. Valve selection was based principally on patient-specific variables (74%), followed by operators' skills (55%), rates of valve-related complications (31%), and device cost (30%). Multislice computed tomography is the imaging modality most frequently performed prior to TAVI. Coronary revascularisation is usually performed before TAVI (86%), while no uniformity was observed in terms of antithrombotic therapy.

The EAPCI survey documents the current TAVI practice and penetration in Europe. Despite economic and regulatory difficulties, the procedure is increasingly performed and mostly according to specific protocols. The heterogeneity of the approach apparent in the survey suggests a call for an update in practice recommendations.