Transcatheter Aortic Valve Implantation in Latin America: Lessons From Chile's Limited Access

Area of Science:

• Cardiology
• Interventional Cardiology
• Health Services Research

Background:

• Transcatheter aortic valve implantation (TAVI) adoption is significantly lower in Latin America compared to the United States and Europe.
• Aortic valve interventions are crucial for managing severe aortic stenosis in the elderly population.

Purpose of the Study:

• To evaluate the utilization and outcomes of TAVI in elderly patients undergoing aortic valve interventions in Chile.
• To compare the in-hospital mortality rates between TAVI and surgical aortic valve replacement (SAVR).

Main Methods:

• Retrospective analysis of 1250 elderly patients (≥75 years) who underwent aortic valve interventions between 2019 and 2023 in Chile.
• Comparison of in-hospital mortality between TAVI and SAVR procedures.

Main Results:

• TAVI was utilized in 55% of patients aged 75 years or older undergoing valve interventions.
• TAVI demonstrated a significant reduction in in-hospital mortality by approximately 46% compared to SAVR.
• The study highlights a substantial gap in TAVI accessibility within Latin American healthcare systems.

Conclusions:

• TAVI is a safe and effective alternative to SAVR for elderly patients with severe aortic stenosis in Chile, associated with lower in-hospital mortality.
• There is a critical need to expand access to TAVI procedures in emerging economies to improve patient outcomes.
• Optimizing healthcare resource allocation and policy is essential for increasing TAVI utilization in Latin America.