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Published on: March 26, 2018
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Changes in aortic valve replacement procedures in Denmark from 2008 to 2020.
Peter Laursen Graversen1, Jawad Haider Butt2, Lauge Østergaard2
1Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark pgra.work@gmail.com.
Heart (British Cardiac Society)
|January 4, 2023
Summary
Transcatheter aortic valve implantation (TAVI) significantly increased aortic valve replacement (AVR) rates in Denmark, becoming the primary procedure for severe aortic stenosis (AS), especially in elderly patients. Hospital stays for AVRs also decreased.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Public Health
Background:
- Severe symptomatic aortic stenosis (AS) management has evolved with the introduction of transcatheter aortic valve implantation (TAVI) since 2007.
- Surgical aortic valve replacement (SAVR) has been the traditional treatment for AS.
Purpose of the Study:
- To compare annual rates of aortic valve replacement (AVR) procedures in Denmark during the TAVI era.
- To assess the proportion of AVRs stratified by age, aligning with current guideline recommendations.
Main Methods:
- Analysis of nationwide Danish registries for first-time AVRs between 2008 and 2020.
- Exclusion of patients without a prior AS diagnosis before AVR.
Main Results:
- AVR rates increased by 39% per million inhabitants from 2008 to 2020.
- TAVI constituted 64.2% of all AVRs and 72.5% of isolated AVRs by 2020, with SAVR decreasing from 2014.
- TAVI use significantly rose across all age groups, accounting for 91.5% of isolated AVRs in patients aged ≥75 years. Hospital stays were reduced for all AVRs.
Conclusions:
- The overall number of AVRs increased due to TAVI adoption, representing a significant shift in treatment strategy for AS.
- TAVI drove the increase in AVR procedures for elderly patients, consistent with guidelines, though it was also increasingly used in younger (<75 years) populations.
- The widespread adoption of TAVI has led to reduced hospital lengths of stay for AVR procedures.
