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- W3108509862 abstract "The Portuguese National Registry of Transcatheter Aortic Valve Implantation records prospectively the characteristics and outcomes of transcatheter aortic valve implantation (TAVI) procedures in Portugal. To assess the 30-day and one-year outcomes of TAVI procedures in Portugal. 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. 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). 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. O Registo Nacional de Cardiologia de Intervenção de Válvulas Aórticas Percutâneas (RNCI-VaP) documenta prospetivamente as características e resultados da VAP em Portugal. Avaliar os resultados a 30 dias e um ano da VAP em Portugal. Comparação dos resultados da VAP de acordo com o acesso (transfemoral – TF versus não transfemoral – não TF). Obtiveram-se curvas de sobrevivência cumulativa de acordo com o acesso, variáveis do procedimento e clínicas. Avaliou-se a segurança precoce (30 dias) do procedimento, de acordo com os critérios Valve Academic Research Consortium-2 (VARC-2). Identificaram-se preditores de mortalidade a 30 dias e um ano. Entre janeiro 2007 e dezembro 2018, realizaram-se 2346 VAP (2242 nativas, 104 Valve-in-Valve [VIV]; idade média 81±7 anos, 53,2% mulheres, EuroSCORE-II [EuroS-II] 4,3%). Sucesso do dispositivo foi obtido em 90,1%, inferior para o não TF (87,0%). Aos 30 dias, a mortalidade global foi de 4,8%, apresentando o TF menor mortalidade (4,3% versus 10,1%, p=0,001) e maior segurança (86,4% versus 72,6%, p<0,001). A mortalidade a um ano foi 11,4%, significativamente menor para o TF (10,5% versus 19,4%, p<0,002). Após análise multivariável, identificaram-se como preditores de mortalidade a 30 dias doença arterial periférica, angioplastia prévia, disfunção ventricular esquerda e classe NYHA III-IV. A um ano, NYHA III-IV, o acesso não TF e a hemorragia com risco de vida foram preditores de mortalidade. A análise de sobrevivência a um ano evidenciou menor sobrevivência para EuroS-II>5% (p<0,001) e VAP não TF (p<0,001). Dados do RNCI-VaP mostram que a VAP foi segura e eficaz. O acesso não TF mostrou segurança em curto prazo. O prognóstico em longo prazo foi influenciado negativamente por este acesso, assim como comorbilidades e o estado clínico de base do doente." @default.
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- W3108509862 date "2020-12-01" @default.
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- W3108509862 title "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" @default.
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- W3108509862 doi "https://doi.org/10.1016/j.repc.2020.02.014" @default.
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