Ait Mokhtar O, Baouni M, Azzouz A, Azaza A, Kara M, Salem M, Dahimene N, Saidane M, Sik A, Ouabdesselam S, Benkhedda S
Service de cardiologie A2, CHU Mustapha. Alger, Algérie; Cardiology oncology collaborative group (COCGR), Algérie.
Service de cardiologie A2, CHU Mustapha. Alger, Algérie.
Ann Cardiol Angeiol (Paris). 2024 Jun;73(3):101765. doi: 10.1016/j.ancard.2024.101765. Epub 2024 May 8.
Trans Aortic Valve Implantation (TAVI) has become the primary treatment for aortic stenosis in patients over 75 years old. Despite its clinical efficacy, it's adoption in emerging countries remains low due to the high cost of prostheses and limited healthcare funding resources. This leads to prolonged waiting times for the TAVI procedure, which may lead to complications; these data are missing particularly in emerging countries.
To describe waiting time for TAVI and mortality rate in this waiting period.
This was prospective registry, patients referred for TAVI were prospectively followed; waiting time was calculated from the first visit after referral to TAVI implantation, clinical and, call fellow up was performed every 3 months. We divided patients into two groups: Group 1 (G1) patients still awaiting TAVI (105 patients), and those who underwent TAVI (36 patients). Group 2 (G2) patients who died while awaiting TAVI (16 patients, 10,2 %).
Demographic characteristics were similar, with a tendency for older age in G2 (79.5 ± 5.7 years vs. 82.5 ± 7.4 years, p=0,06). G2 exhibited more left ventricular ejection fraction (LVEF) impairment (8.5% vs. 25%, p=0,03) and a higher rate of severe heart failure with dyspnea stages III or IV (2.8% vs. 12.5%, p<0,001). The mean follow-up in G1 was 242.9 ± 137.4 days; the waiting time for TAVI was 231.7 ± 134.1 days, and the average time between the first consultation and death while awaiting TAVI (G2) was 335.1 ± 167.4 days.
in our series, waiting time is high due to limited Trans aortic heart valve availability, mortality during this wait exceeds 10%. Adverse prognostic factors include impaired LVEF and severe dyspnea stages III or IV.
经导管主动脉瓣植入术（TAVI）已成为75岁以上主动脉瓣狭窄患者的主要治疗方法。尽管其临床疗效显著，但由于假体成本高昂且医疗保健资金资源有限，在新兴国家的采用率仍然很低。这导致TAVI手术的等待时间延长，可能会引发并发症；这些数据在新兴国家尤为缺乏。
描述TAVI的等待时间以及在此等待期内的死亡率。
这是一项前瞻性登记研究，对转诊接受TAVI的患者进行前瞻性随访；等待时间从转诊后首次就诊至TAVI植入计算得出，每3个月进行临床随访及电话随访。我们将患者分为两组：第1组（G1）仍在等待TAVI的患者（105例），以及接受了TAVI的患者（36例）。第2组（G2）在等待TAVI期间死亡的患者（16例，占10.2%）。
人口统计学特征相似，G2组有年龄较大的趋势（79.5±5.7岁 vs. 82.5±7.4岁，p = 0.06）。G2组左心室射血分数（LVEF）受损情况更多（8.5% vs. 25%，p = 0.03），重度心力衰竭伴III或IV级呼吸困难的发生率更高（2.8% vs. 12.5%，p < 0.001）。G1组的平均随访时间为242.9±137.4天；TAVI的等待时间为231.7±134.1天，而在等待TAVI期间首次就诊至死亡的平均时间（G2组）为335.1±167.4天。
在我们的研究系列中，由于经导管主动脉心脏瓣膜供应有限，等待时间较长，在此等待期间的死亡率超过10%。不良预后因素包括LVEF受损以及III或IV级重度呼吸困难。
