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[Transcatheter aortic-valve implantation. A ten years clinical experience]
Gonzalo Martínez1, Alberto Fuensalida1, Pablo Sepúlveda1
1División de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Santiago, Chile.
Background:
Transcatheter aortic-valve implantation (TAVI) was introduced in 2002 and the first implants in our country were performed in 2010.
Aim:
To review the TAVI experience in our hospital, considering the technology improvements and gained experience throughout this period.
Material And Methods:
All patients undergoing TAVI in our center were included. Results and complications were adjudicated according to the Valve Academic Research Consortium-2 (VARC-2) criteria. Patients were divided in 3 groups, according to procedural year: Period 1: 2010-2015 (n = 35); Period 2: 2016-2018 (n = 35); Period 3: 2019-2021 (n = 41). Mortality up to one year after the procedure was recorded.
Results:
Between 2010 and 2021, 111 TAVI procedures were performed. The mean age of patients was 82 years and 47% were women. Risk scores for in-hospital mortality were STS 6.7%, EUROSCORE II 8.0% and ACC/STS TAVR Score 4.9%. The trans-femoral route was used in 88% and a balloon-expandable valve was chosen in 82% of patients. A successful implant was achieved in 96%, with an in-hospital mortality of 1.8%. Mortality at 30 days and 1-year were 2.7 and 9.0%, respectively. During period 3, 100% of implants were successful, with no in-hospital mortality, less vascular complications (p < 0.01), less stroke (p = 0.04), less severe paravalvular leak (p = 0.01) and significantly lower rate of acute complications (p < 0.01).
Conclusions:
TAVI achieves excellent results. With greater experience and better available technologies, these results are even more favorable.
