Universidade de São Paulo - Faculdade de Medicina Hospital das Clínicas - Instituto do Coração, São Paulo, SP - Brasil.
Hospital Samaritano Paulista, São Paulo, SP - Brasil.
Arq Bras Cardiol. 2022 Jun 10;118(6):1085-1096. doi: 10.36660/abc.20210327. eCollection 2022.
Transcatheter aortic valve replacement (TAVR) is a worldwide adopted procedure with rapidly evolving practices. Regional and temporal variations are expected to be found.
To compare TAVR practice in Latin America with that around the world and to assess its changes in Latin America from 2015 to 2020.
A survey was applied to global TAVR centers between March and September 2015, and again to Latin-American centers between July 2019 and January 2020. The survey consisted of questions addressing: i) center's general information; ii) pre-TAVR evaluation; iii) procedural techniques; iv) post-TAVR management; v) follow-up. Answers from the 2015 survey of Latin-American centers (LATAM15) were compared with those of other centers around the world (WORLD15) and with the 2020 updated Latin-American survey (LATAM20). A 5% level of significance was adopted for statistical analysis.
250 centers participated in the 2015 survey (LATAM15=29; WORLD15=221) and 46 in the LATAM20. Combined centers experience accounted for 73 707 procedures, with WORLD15 centers performing, on average, 6- and 3-times more procedures than LATAM15 and LATAM20 centers, respectively. LATAM centers performed less minimalistic TAVR than WORLD15 centers, but there was a significant increase in less invasive procedures after 5 years in Latin-American centers. For postprocedural care, a lower period of telemetry and maintenance of temporary pacing wire, along with less utilization of dual antiplatelet therapy was observed in LATAM20 centers.
Despite still having a much lower number of procedures, many aspects of TAVR practice in Latin-American centers have evolved in recent years, followingthe trend observed in developed country centers.
经导管主动脉瓣置换术（TAVR）是一种在全球范围内广泛采用的手术方法，其操作实践也在不断发展。预计会发现地区和时间上的差异。
比较拉丁美洲与全球的 TAVR 实践，并评估拉丁美洲从 2015 年到 2020 年的变化。
2015 年 3 月至 9 月期间，对全球 TAVR 中心进行了一项调查，2019 年 7 月至 2020 年 1 月期间再次对拉丁美洲中心进行了调查。调查内容包括：i）中心的一般信息；ii）TAVR 前评估；iii）手术技术；iv）TAVR 后管理；v）随访。将拉丁美洲中心（LATAM15）2015 年调查的答案与其他全球中心（WORLD15）的答案进行比较，并与 2020 年更新的拉丁美洲调查（LATAM20）进行比较。采用 5%的显著性水平进行统计分析。
250 个中心参与了 2015 年的调查（LATAM15=29；WORLD15=221），46 个中心参与了 LATAM20 调查。综合中心的经验涉及 73707 例手术，WORLD15 中心的手术量平均分别是 LATAM15 和 LATAM20 中心的 6 倍和 3 倍。与 WORLD15 中心相比，LATAM 中心进行的微创 TAVR 较少，但在拉丁美洲中心，5 年后，微创程序的比例显著增加。在术后护理方面，LATAM20 中心的遥测和临时起搏线维持时间较短，双联抗血小板治疗的使用率也较低。
尽管拉丁美洲中心的手术数量仍然少得多，但近年来，TAVR 实践的许多方面都在不断发展，与发达国家中心的趋势一致。
