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Short and long-term clinical impact of transcatheter aortic valve implantation in Portugal according to different access routes: Data from the Portuguese National Registry of TAVI

2020Journal article Open access
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dc.contributor.authorGuerreiro, Cláudio
dc.contributor.authorFerreira, Pedro Carrilho
dc.contributor.authorTeles, Rui Campante
dc.contributor.authorBraga, Pedro
dc.contributor.authorCanas da Silva, Pedro
dc.contributor.authorPatrício, Lino
dc.contributor.authorSilva, João Carlos
dc.contributor.authorBaptista, José
dc.contributor.authorde Sousa Almeida, Manuel
dc.contributor.authorGama Ribeiro, Vasco
dc.contributor.authorSilva, Bruno
dc.contributor.authorBrito, João
dc.contributor.authorInfante Oliveira, Eduardo
dc.contributor.authorCacela, Duarte
dc.contributor.authorMadeira, Sérgio
dc.contributor.authorSilveira, João
dc.date.accessioned2022-07-12T11:40:00Z
dc.date.available2022-07-12T11:40:00Z
dc.date.issued2020
dc.description.abstractIntroduction: The Portuguese National Registry of Transcatheter Aortic Valve Implantation records prospectively the characteristics and outcomes of transcatheter aortic valve implantation (TAVI) procedures in Portugal. Objectives: To assess the 30-day and one-year outcomes of TAVI procedures in Portugal. Methods: We compared TAVI results according to the principal access used (transfemoral (TF) vs. non-transfemoral (non-TF)). Cumulative survival curves according to access route, other procedural and clinical variables were obtained. The Valve Academic Research Consortium-2 (VARC-2) composite endpoint of early (30-days) safety was assessed. VARC-2 predictors of 30-days and 1-year all-cause mortality were identified. Results: Between January 2007 and December 2018, 2346 consecutive patients underwent TAVI (2242 native, 104 valve-in-valve; mean age 81±7 years, 53.2% female, EuroSCORE-II - EuroS-II, 4.3%). Device success was 90.1% and numerically lower for non-TF (87.0%). Thirty-day all-cause mortality was 4.8%, with the TF route rendering a lower mortality rate (4.3% vs. 10.1%, p=0.001) and higher safety endpoint (86.4% vs. 72.6%, p<0.001). The one-year all-cause mortality rate was 11.4%, and was significantly lower for TF patients (10.5% vs. 19.4%, p<0.002). After multivariate analysis, peripheral artery disease, previous percutaneous coronary intervention, left ventricular dysfunction and NYHA class III-IV were independent predictors of 30-day all-cause mortality. At one-year follow-up, NYHA class III-IV, non-TF route and occurrence of life-threatening bleeding predicted mortality. Kaplan-Meier survival analysis of the first year of follow-up shows decreased survival for patients with an EuroS-II>5% (p<0.001) and who underwent non-TF TAVI (p<0.001). Conclusion: Data from our national real-world registry showed that TAVI was safe and effective. The use of a non-transfemoral approach demonstrated safety in the short term. Long-term prognosis was, however, adversely associated with this route, with comorbidities and the baseline clinical status.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationGuerreiro C, Ferreira PC, Teles RC, et al. Short and long-term clinical impact of transcatheter aortic valve implantation in Portugal according to different access routes: Data from the Portuguese National Registry of TAVI. Rev Port Cardiol (Engl Ed). 2020;39(12):705-717. doi:10.1016/j.repc.2020.02.014pt_PT
dc.identifier.doi10.1016/j.repc.2020.02.014pt_PT
dc.identifier.issn2174-2049
dc.identifier.urihttp://hdl.handle.net/10400.16/2709
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0870255120304364?via%3Dihubpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectSevere aortic valvular diseasept_PT
dc.subjectTAVIpt_PT
dc.subjectHeart failurept_PT
dc.titleShort and long-term clinical impact of transcatheter aortic valve implantation in Portugal according to different access routes: Data from the Portuguese National Registry of TAVIpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceSpainpt_PT
oaire.citation.endPage717pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage705pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume39pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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