Is Transcatheter Aortic Valve Implantation (TAVI) Activity in Australia Consistent With International Guidelines?

Area of Science:

• Cardiovascular medicine
• Interventional cardiology
• Health services research

Background:

• Transcatheter aortic valve implantation (TAVI) adoption in Australia commenced later than in Europe and America.
• Initial TAVI uptake in Australia lagged behind international benchmarks.
• This study provides an updated analysis of TAVI activity within Australia.

Purpose of the Study:

• To assess the current status and trends of TAVI procedures in Australia.
• To compare Australian TAVI activity with international standards and surgical aortic valve replacement (SAVR).

Main Methods:

• A population-level epidemiological study design was employed.
• Utilized Australian Institute of Health and Welfare (AIHW) data for TAVI and SAVR from 2012-2022.
• Incorporated Australian Bureau of Statistics (ABS) population data to analyze trends in absolute, population-adjusted, and age cohort-adjusted activity.

Main Results:

• Despite the COVID-19 pandemic, TAVI activity in Australia has significantly increased.
• Annual TAVI procedures now exceed SAVR procedures (3,967 vs 3,870), primarily driven by patients aged 85 years and older.
• Population-adjusted TAVI activity in Australia surpasses the European average (15.3 vs 14.1 per 100,000).
• The 75-79 age group shows equipoise between SAVR and TAVI (50% vs 50%).

Conclusions:

• Australian TAVI activity levels are now comparable to international best practices.
• TAVI has become a leading treatment modality for aortic valve replacement in Australia, especially in elderly cohorts.