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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
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Trends in aortic valve replacement for aortic stenosis: a French nationwide study
Virginia Nguyen1, Nadav Willner2, Helene Eltchaninoff3
1Cardiology Department, Centre Cardiologique du Nord, Saint-Denis, France.
European Heart Journal
|October 25, 2022
Summary
Transcatheter aortic valve replacement (TAVR) is now the dominant procedure for aortic valve stenosis, with outcomes improving over time. TAVR is recommended as a first option for patients 75 and older, though pacemaker rates and hospital stays need improvement.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Services Research
Background:
- Transcatheter aortic valve replacement (TAVR) offers an alternative to surgical aortic valve replacement (SAVR) for aortic valve stenosis (AS).
- Nationwide data on TAVR implementation, its impact on SAVR, and comparative outcomes are limited.
Purpose of the Study:
- To analyze the trends in TAVR and SAVR procedures in France from 2007 to 2019.
- To compare the outcomes and complication rates of TAVR versus SAVR.
Main Methods:
- Utilized a French administrative hospital-discharge database to collect data on all aortic valve replacements (AVRs).
- Analyzed 106,253 isolated SAVR, 46,514 combined SAVR, and 65,651 TAVR procedures performed between 2007 and 2019.
Main Results:
- AVR numbers doubled, with TAVR becoming dominant by 2018.
- In-hospital mortality declined for both TAVR and SAVR; TAVR outcomes were similar or better in patients ≥75 years.
- TAVR showed declining complication rates, but permanent pacemaker rates (16.7%) and median length of stay (6 days) remained substantial.
Conclusions:
- TAVR is the predominant AVR method, with improved patient profiles and outcomes.
- TAVR should be considered the primary option for patients aged 75 and older.
- Further improvements are needed in reducing permanent pacemaker implantation and length of stay following TAVR.
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