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Patterns of Aortic Valve Replacement in Europe: Adoption by Age
Tanja Rudolph1, Clare Appleby2, Victoria Delgado3
1General and Interventional Cardiology/Angiology, Heart and Diabetes Centre Nord Rhine-Westphalia, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany.
Cardiology
|August 16, 2023
Summary
Aortic valve replacement (AVR) use and transcatheter aortic valve implantation (TAVI) adoption vary significantly across European countries. TAVI is increasingly used, especially for older patients undergoing aortic valve replacement.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Health Services Research
Background:
- Severe aortic stenosis management strategies can differ based on patient age.
- Understanding age-stratified aortic valve replacement (AVR) patterns is crucial for optimizing patient care.
Purpose of the Study:
- To analyze and compare the utilization of aortic valve replacement (AVR) procedures across various European countries.
- To examine age-specific trends in AVR, including surgical AVR (sAVR) and transcatheter aortic valve implantation (TAVI).
Main Methods:
- Utilized procedure volume data for sAVR and TAVI from 2015-2020 across twelve European nations.
- Calculated patients per million (PPM) undergoing AVR, stratified by age groups.
- Analyzed population estimates to determine AVR rates.
Main Results:
- Significant variations in AVR PPM were observed between countries (e.g., Germany 508 PPM, Poland 174 PPM in 2020).
- Transcatheter aortic valve implantation (TAVI) adoption rates ranged from 25% (Poland) to 61% (Switzerland, Finland).
- AVR procedures increased with age, peaking at 80-84 years, with substantial growth in patients aged ≥80 years.
Conclusions:
- Considerable disparities exist in AVR utilization and TAVI vs. sAVR adoption rates among European countries.
- Transcatheter aortic valve implantation (TAVI) use has risen, particularly in elderly patient populations.
- Age-specific management of severe aortic stenosis requires tailored approaches, considering regional variations in treatment modalities.
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