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Temporal Trends of Transcatheter Aortic Valve Implantation over 12 Years: A High-Volume Single-Center Experience.

作者信息

Frydman Shir, Zahler David, Merdler Ilan, Freund Ophir, Shacham Yacov, Banai Shmuel, Finkelstein Ariel, Steinvil Arie

机构信息

Department of Cardiology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.

出版信息

J Clin Med. 2022 Aug 24;11(17):4962. doi: 10.3390/jcm11174962.


DOI:10.3390/jcm11174962
PMID:36078899
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9456499/
Abstract

Transcatheter aortic valve replacement (TAVR) has become the mainstay of treatment for patients with severe AS. Since the TAVR population and patients’ outcomes have dramatically changed over the last decade, updated data regarding contemporary practice and trends are pertinent to clinical use. We performed a retrospective observational analysis of consecutive patient who underwent TAVR for symptomatic severe AS between the years 2009 and 2021 in a single high-volume center. Patients were divided into four equal time groups based on the procedure date (2009−2012, 2013−2015, 2016−2018 and 2019−2021). A total of 1988 patients were included in this study and divided into four groups, with 321, 482, 565 and 620 patients in groups 1−4, respectively. Significant trends were seen in baseline characteristics of a few parameters, including lower age, lower procedural risk and reduced rates of comorbidity (p for trend < 0.0001 for all factors mentioned above). A shift was seen in the procedural technique with lower balloon pre-dilatation and higher device success rates (p for trend < 0.0001). The post-procedural period changed over the years with fewer pacemaker placements (p < 0.0001) and reduced rates of AKI and post-procedural bleed (p value 0.02 and <0.0001, respectively). Furthermore, overall hospital stay was shortened from 7 ± 7.1 days to 2.3 ± 1.7 (p < 0.0001). Finally, patient follow up revealed reduced mortality rates at 30 days (p < 0.0001) and 1 year (p = 0.013). Multivariate regression revealed that a late implantation date was an independent protector from mortality (HR 0.84, p = 0.002). In conclusion, our study demonstrated that TAVR has become a safer practice over the years with reduced rates of morbidity and mortality.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b512/9456499/0eebdced3400/jcm-11-04962-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b512/9456499/6c649aff9d19/jcm-11-04962-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b512/9456499/0eebdced3400/jcm-11-04962-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b512/9456499/6c649aff9d19/jcm-11-04962-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b512/9456499/0eebdced3400/jcm-11-04962-g002.jpg

相似文献

[1]
Temporal Trends of Transcatheter Aortic Valve Implantation over 12 Years: A High-Volume Single-Center Experience.

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[2]
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[3]
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[6]
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[7]
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[8]
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[9]
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引用本文的文献

[1]
Trends and Outcomes of TAVR: An Analysis Using the National Inpatient Sample and Readmissions Database.

Diseases. 2025-5-13

[2]
Temporal Trends in Patient Characteristics and Clinical Outcomes of TAVR: Over a Decade of Practice.

J Clin Med. 2024-8-25

[3]
A single-center clinical study of acute kidney injury associated with acute myocardial infarction.

Int Urol Nephrol. 2024-1

本文引用的文献

[1]
2021 ESC/EACTS Guidelines for the management of valvular heart disease.

Eur Heart J. 2022-2-12

[2]
TAVR: A Review of Current Practices and Considerations in Low-Risk Patients.

J Interv Cardiol. 2020

[3]
Shifting Trends in Timing of Pacemaker Implantation After Transcatheter Aortic Valve Replacement.

JACC Cardiovasc Interv. 2021-1-25

[4]
Evolution of outcome and complications in TAVR: a meta-analysis of observational and randomized studies.

Sci Rep. 2020-9-23

[5]
Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve Replacement: JACC Review Topic of the Week.

J Am Coll Cardiol. 2019-10-22

[6]
Pre-Dilatation Versus No Pre-Dilatation for Implantation of a Self-Expanding Valve in All Comers Undergoing TAVR: The DIRECT Trial.

JACC Cardiovasc Interv. 2019-3-27

[7]
Trends in complete heart block after transcatheter aortic valve replacement: A population based analysis.

Catheter Cardiovasc Interv. 2019-2-21

[8]
Individual Operator Experience and Outcomes in Transcatheter Aortic Valve Replacement.

JACC Cardiovasc Interv. 2018-12-12

[9]
Length of Stay and Discharge Disposition After Transcatheter Versus Surgical Aortic Valve Replacement in the United States.

Circ Cardiovasc Interv. 2018-9

[10]
Trends in patient characteristics and clinical outcome over 8 years of transcatheter aortic valve implantation.

Neth Heart J. 2018-9

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