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Esteves V, de Andrade PB, Zukowski CN, Araujo E, Bezerra CG, Oliveira AD, de Melo EP, Gama G, Cantarelli R, Mattos LAPE, Tedeschi A, Loures VA, Vahle V, Silva GBG, Rati MAN, Lopes AC, Fé NDM, Alves G, Tavares SC, Kreimer S, Tebet M, Maia F, de Oliveira MS, Fonseca A, Camiletti A, de Albuquerque DC, de Souza OF. Temporal Trends in Transcatheter Aortic Valve Implantation: 10-Year Analysis of the TAVIDOR Registry. Arq Bras Cardiol 2024; 121:e20230467. [PMID: 38896588 PMCID: PMC11164433 DOI: 10.36660/abc.20230467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/18/2023] [Accepted: 03/13/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) has established itself as the preferential strategy to approach severe aortic stenosis. Information on procedural improvements and nationwide results obtained with the technique throughout the past decade are unknown. OBJECTIVES To assess the temporal variation of the demographic profile, procedural characteristics, and in-hospital outcomes of patients undergoing TAVI procedures at the Rede D'Or São Luiz. METHODS Observational registry comprising 29 national institutions, comparing the characteristics of the TAVI procedures performed from 2012 to 2017 (Group 1) to those performed from 2018 to 2023 (Group 2). The statistical significance level adopted was p < 0.05. RESULTS This study assessed 661 patients, 95 in Group 1 and 566 in Group 2, with a mean age of 81.1 years. Group 1 patients had a higher prevalence of New York Heart Association functional class III or IV and STS risk score > 8%. In addition, they more often underwent general anesthesia, transesophageal echocardiographic monitoring, and access through femoral dissection. Group 2 patients had a higher success rate of the TAVI procedure (95.4% versus 89.5%; p = 0.018), lower mortality (3.9% versus 11.6%; p = 0.004), and less often needed permanent pacemaker implantation (8.5% versus 17.9%; p = 0.008). CONCLUSIONS The 10-year temporal trends analysis of the TAVIDOR Registry shows a reduction in patients' clinical complexity over time. Furthermore, the advance to minimalistic implantation techniques, added to the technological evolution of the devices, may have contributed to the favorable outcomes observed among those whose implantation occurred in the last 5 years studied.
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Affiliation(s)
- Vinicius Esteves
- Rede D’Or São LuizSão PauloSPBrasilRede D’Or São Luiz, São Paulo, SP – Brasil
| | - Pedro Beraldo de Andrade
- Rede D’Or São LuizSão PauloSPBrasilRede D’Or São Luiz, São Paulo, SP – Brasil
- Santa Casa de Misericórdia de MaríliaMaríliaSPBrasilSanta Casa de Misericórdia de Marília – Cardiologia Invasiva, Marília, SP – Brasil
| | - Cleverson Neves Zukowski
- Hospital Copa D’OrRio de JaneiroRJ BrasilHospital Copa D’Or, Rio de Janeiro, RJ – Brasil
- Hospital Quinta D’OrRio de JaneiroRJBrasilHospital Quinta D’Or, Rio de Janeiro, RJ – Brasil
| | - Edmur Araujo
- Hospital do Coração do BrasilBrasíliaRJBrasilHospital do Coração do Brasil, Brasília, RJ – Brasil
| | - Cristiano Guedes Bezerra
- Universidade Federal da BahiaSalvadorBABrasilUniversidade Federal da Bahia – Hemodinâmica e Cardiologia Intervencionista, Salvador, BA – Brasil
| | | | | | - Gustavo Gama
- UDI HospitalSão LuísMABrasilUDI Hospital, São Luís, MA – Brasil
| | - Rodrigo Cantarelli
- Hospital Memorial São JoséRecifePEBrasilHospital Memorial São José, Recife, PE – Brasil
| | | | - Angelo Tedeschi
- Rede D’Or São LuizRio de JaneiroRJBrasilRede D’Or São Luiz, Rio de Janeiro, RJ – Brasil
| | - Vitor Alves Loures
- Hospital São Luiz Anália FrancoSão PauloSPBrasilHospital São Luiz Anália Franco, São Paulo, SP – Brasil
| | - Vitor Vahle
- Hospital São LucasAracajuSEBrasilHospital São Lucas, Aracaju, SE – Brasil
| | | | | | - Augusto Celso Lopes
- Hospital Monte KlinikumFortalezaCEBrasilHospital Monte Klinikum, Fortaleza, CE – Brasil
| | - Nilson de Moura Fé
- Hospital São CarlosFortalezaCEBrasilHospital São Carlos, Fortaleza, CE – Brasil
| | - Gustavo Alves
- Rede D’Or São LuizRio de JaneiroRJBrasilRede D’Or São Luiz, Rio de Janeiro, RJ – Brasil
| | | | - Sergio Kreimer
- Hospital e Maternidade BrasilSanto AndréSPBrasilHospital e Maternidade Brasil, Santo André, SP – Brasil
| | - Marden Tebet
- Rede D’Or São LuizSão PauloSPBrasilRede D’Or São Luiz, São Paulo, SP – Brasil
| | - Felipe Maia
- Universidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ – Brasil
| | - Maurício Sales de Oliveira
- Hospital Copa D’OrRio de JaneiroRJ BrasilHospital Copa D’Or, Rio de Janeiro, RJ – Brasil
- Hospital Quinta D’OrRio de JaneiroRJBrasilHospital Quinta D’Or, Rio de Janeiro, RJ – Brasil
| | - Alberto Fonseca
- Hospital do Coração do BrasilBrasíliaRJBrasilHospital do Coração do Brasil, Brasília, RJ – Brasil
| | - Angelina Camiletti
- Rede D’Or São LuizSão PauloSPBrasilRede D’Or São Luiz, São Paulo, SP – Brasil
| | - Denilson Campos de Albuquerque
- Universidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ – Brasil
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