Temporal trends in TAVI outcomes: experience from an Irish tertiary referral centre

Transcatheter aortic valve implantation (TAVI) has become a well-established therapeutic option for severe aortic stenosis in recent decades. There is limited data published about Irish experiences with TAVI.

To characterize contemporary TAVI outcomes from an Irish tertiary referral centre.

A retrospective registry was created which included data on consecutive patients who underwent TAVI in our centre over a 3-year period. The Valve Academic Research Consortium 3 guideline was used to define endpoint definitions.

A total of 230 TAVI procedures were performed; 62 (2019), 57 (2020) and 111 (2021). Cumulative mean age was 81 years, with a male majority (65%). Median hospital length-of-stay was lower in 2021 versus 2019 [3 days (IQR 2 to 10) versus 9 days (IQR 4-22), p = 0.008]. Of patients with at least 30-day follow-up data (95.3%), none experienced procedural or 30-day mortality. Cumulative all-cause mortality was 22% over a median follow-up of 491 days (IQR 323 to 780). The incidence of in-hospital cerebro-vascular accidents was higher in 2019 versus 2021 (9.7% versus 1.8%, p = 0.02). A pacemaker was implanted in 20 (9%) cases, while 28 (12%) patients experienced an acute kidney injury. There was a general trend towards temporal improvements in complication rates across the years.

The TAVI caseload has risen significantly in our centre in recent years. Overall, peri-procedural complication rates have been low and device success rates high, consistent with international registry data. There have been temporal improvements in the majority of TAVI-related complications and length of hospital stay with increasing operator experience.