de Wilde Elisa, Olivetti Leonardo, James Stefan, Christersson Christina, Buccheri Sergio, Lindblom Rickard, Amin Azad, Sarno Giovanna
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Uppsala Clinical Research Center, Uppsala, Sweden.
Ups J Med Sci. 2025 Feb 28;130. doi: 10.48101/ujms.v130.10999. eCollection 2025.
In recent years, transcatheter aortic valve implantation (TAVI) has rapidly emerged as a key treatment option for aortic stenosis. TAVI has been performed at Uppsala University Hospital since 2009. Data on TAVI procedures have been collected in a nation-wide all-comer registry, the Swedish Transcatheter Cardiac Intervention Registry (SWENTRY). However, only limited analysis has been conducted on trends in short- and long-term outcomes of TAVI patients in Sweden.
This registry-based cohort study aims to evaluate outcome trends and long-term prognosis in patients who underwent TAVI in a Swedish single center between 2009 and 2023. Survival outcomes were studied using the Kaplan-Meier method. Cox Proportional Hazards models were used to adjust for differences in patient characteristics over time.
In total, 1,741 TAVI procedures were performed between 2009 and 2023. Immediate procedural mortality and 1-year mortality averaged at 0.9 and 8.1%, respectively. Both procedural and long-term mortality showed a decreasing trend over time. Similar results were observed when controlling for comorbidities and age.
Short-term outcomes and long-term prognosis have been constantly improving for patients undergoing TAVI within this study. Similar mortality and complication trends have been observed in other registry studies. These trends may be attributed to improvements in the quality of care, and the increased use of TAVI in lower risk patients.
近年来，经导管主动脉瓣植入术（TAVI）已迅速成为主动脉瓣狭窄的关键治疗选择。自2009年以来，乌普萨拉大学医院一直在开展TAVI手术。TAVI手术的数据已收集在一个全国性的所有患者登记处，即瑞典经导管心脏介入登记处（SWENTRY）。然而，对于瑞典TAVI患者的短期和长期结局趋势，仅进行了有限的分析。
这项基于登记处的队列研究旨在评估2009年至2023年期间在瑞典单一中心接受TAVI手术的患者的结局趋势和长期预后。使用Kaplan-Meier方法研究生存结局。采用Cox比例风险模型来调整患者特征随时间的差异。
2009年至2023年期间共进行了1741例TAVI手术。手术即刻死亡率和1年死亡率平均分别为0.9%和8.1%。手术死亡率和长期死亡率均随时间呈下降趋势。在控制合并症和年龄时也观察到了类似结果。
在本研究中，接受TAVI手术的患者短期结局和长期预后一直在不断改善。在其他登记处研究中也观察到了类似的死亡率和并发症趋势。这些趋势可能归因于护理质量的提高以及TAVI在低风险患者中的使用增加。
