Temporal trends in patient characteristics and transcatheter aortic valve implantation procedures over four years at the University Hospital Centre Split

    Authors

    Keywords

    aortic stenosis, transcatheter aortic valve implantation, clinical characteristics

    DOI

    https://doi.org/10.15836/ccar2024.462

    Full Text

    **Introduction:** The aim of this study is to determine whether there are differences in the clinical, laboratory and procedural characteristics (1-3) of patients treated with transcatheter aortic valve implantation (TAVI) at University Hospital Centre Split in 2019-2020 and 2023. **Patients and Methods**: The study included 187 patients diagnosed with severe aortic stenosis who underwent TAVI during 2019, 2020 and 2023. Basic clinical and procedural data were collected from the hospital’s information system and archives. To compare the outcomes, patients were divided into two groups: the 2019-2020 group and the 2023 group. **Results**: The 2019-2020 group had 39 patients, while the 2023 group had 148 patients. The median age for the entire cohort was 82 years (IQR=6.5), with no significant change over time (P=0.366). The proportion of patients aged ≤75 years remained the same (15.38% in 2019-2020 and 16.22% in 2023). The 2023 group had a significantly shorter median hospital stay, 3 days compared to 6 days in the 2019-2020 group (P<0.001). The estimated EuroSCORE II decreased from 4.4% to 3.71% in 2023 (P=0.649). In the 2023 group there were more patients classified as New York Heart Association (NYHA) class 4 for heart failure (12.84% compared to 0% in 2019-2020; P=0.054). In the entire cohort, 81.82% of patients had arterial hypertension, 39.57% had atrial fibrillation, and 33.16% had diabetes. No significant differences were found in most comorbidities between the two groups. The 2019-2020 group had significantly more patients who had previously undergone percutaneous coronary intervention (33.33% vs. 14.19%, in 2023; P=0.012). The use of balloon pre-dilation and post-dilation did not change significantly over time. The transfemoral access was most commonly used, although a small number of procedures in 2023 were performed using the transaxillary access. In the entire cohort, the most commonly implanted valve was the Medtronic Evolut PRO + (31.5%, N=57) and Edwards Sapien 3 (25.4%, N=46). **Conclusion:** Over the four-year period, there has been a significant increase in TAVI procedures, with the use of various types of valves and vascular access routes, and more complex procedures. The length of hospital stay has been significantly reduced. The comorbidities burden and patient age did not change significantly during the observed period.

    Literature

    1. Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2022 February 12;43(7):561–632. https://doi.org/10.1093/eurheartj/ehab395
    2. Carroll JD, Mack MJ, Vemulapalli S, Herrmann HC, Gleason TG, Hanzel G, et al. STS-ACC TVT Registry of Transcatheter Aortic Valve Replacement. J Am Coll Cardiol. 2020 November 24;76(21):2492–516. https://doi.org/10.1016/j.jacc.2020.09.595
    3. Bulum J, Ostojić Z, Strozzi M, Šafradin I, Ivančan V, Šeparović-Hanževački J, et al. Transcatether aortic valve impalnatation () in treatment of patients with severe aortic stenosis: method review and results from Zagreb university hospital center. Lijec Vjesn. 2017;139(3-4):82–90. https://hrcak.srce.hr/184340
    Cardiologia Croatica
    Back to search

    Temporal trends in patient characteristics and transcatheter aortic valve implantation procedures over four years at the University Hospital Centre Split

    Extended Abstract
    Issue11-12
    Published
    Pages462
    PDF via DOIhttps://doi.org/10.15836/ccar2024.462
    aortic stenosis
    transcatheter aortic valve implantation
    clinical characteristics

    Authors

    Anita Jukić*ORCIDUniversity Hospital Centre Split, Split, Croatia
    Monika Lorena ČotićORCIDUniversity of Split, Split, Croatia
    Frane RunjićORCIDUniversity Hospital Centre Split, Split, Croatia
    Ivica KristićORCIDUniversity Hospital Centre Split, Split, Croatia

    *Correspondence email: anitajkc@gmail.com

    Full Text

    Introduction: The aim of this study is to determine whether there are differences in the clinical, laboratory and procedural characteristics (1–3) of patients treated with transcatheter aortic valve implantation (TAVI) at University Hospital Centre Split in 2019-2020 and 2023.

    Patients and Methods: The study included 187 patients diagnosed with severe aortic stenosis who underwent TAVI during 2019, 2020 and 2023. Basic clinical and procedural data were collected from the hospital’s information system and archives. To compare the outcomes, patients were divided into two groups: the 2019-2020 group and the 2023 group.

    Results: The 2019-2020 group had 39 patients, while the 2023 group had 148 patients. The median age for the entire cohort was 82 years (IQR=6.5), with no significant change over time (P=0.366). The proportion of patients aged ≤75 years remained the same (15.38% in 2019-2020 and 16.22% in 2023). The 2023 group had a significantly shorter median hospital stay, 3 days compared to 6 days in the 2019-2020 group (P<0.001). The estimated EuroSCORE II decreased from 4.4% to 3.71% in 2023 (P=0.649). In the 2023 group there were more patients classified as New York Heart Association (NYHA) class 4 for heart failure (12.84% compared to 0% in 2019-2020; P=0.054). In the entire cohort, 81.82% of patients had arterial hypertension, 39.57% had atrial fibrillation, and 33.16% had diabetes. No significant differences were found in most comorbidities between the two groups. The 2019-2020 group had significantly more patients who had previously undergone percutaneous coronary intervention (33.33% vs. 14.19%, in 2023; P=0.012). The use of balloon pre-dilation and post-dilation did not change significantly over time. The transfemoral access was most commonly used, although a small number of procedures in 2023 were performed using the transaxillary access. In the entire cohort, the most commonly implanted valve was the Medtronic Evolut PRO + (31.5%, N=57) and Edwards Sapien 3 (25.4%, N=46).

    Conclusion: Over the four-year period, there has been a significant increase in TAVI procedures, with the use of various types of valves and vascular access routes, and more complex procedures. The length of hospital stay has been significantly reduced. The comorbidities burden and patient age did not change significantly during the observed period.

    Literature

    1. 1.
      Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2022 February 12;43(7):561–632.DOI
    2. 2.
      Carroll JD, Mack MJ, Vemulapalli S, Herrmann HC, Gleason TG, Hanzel G, et al. STS-ACC TVT Registry of Transcatheter Aortic Valve Replacement. J Am Coll Cardiol. 2020 November 24;76(21):2492–516.DOI
    3. 3.
      Bulum J, Ostojić Z, Strozzi M, Šafradin I, Ivančan V, Šeparović-Hanževački J, et al. Transcatether aortic valve impalnatation () in treatment of patients with severe aortic stenosis: method review and results from Zagreb university hospital center. Lijec Vjesn. 2017;139(3-4):82–90.Link