Temporal trends in TAVI outcomes: experience from an Irish tertiary referral centre
- PMID: 40637949
- DOI: 10.1007/s11845-025-04001-7
Temporal trends in TAVI outcomes: experience from an Irish tertiary referral centre
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has become a well-established therapeutic option for severe aortic stenosis in recent decades. There is limited data published about Irish experiences with TAVI.
Aims: To characterize contemporary TAVI outcomes from an Irish tertiary referral centre.
Methods: A retrospective registry was created which included data on consecutive patients who underwent TAVI in our centre over a 3-year period. The Valve Academic Research Consortium 3 guideline was used to define endpoint definitions.
Results: A total of 230 TAVI procedures were performed; 62 (2019), 57 (2020) and 111 (2021). Cumulative mean age was 81 years, with a male majority (65%). Median hospital length-of-stay was lower in 2021 versus 2019 [3 days (IQR 2 to 10) versus 9 days (IQR 4-22), p = 0.008]. Of patients with at least 30-day follow-up data (95.3%), none experienced procedural or 30-day mortality. Cumulative all-cause mortality was 22% over a median follow-up of 491 days (IQR 323 to 780). The incidence of in-hospital cerebro-vascular accidents was higher in 2019 versus 2021 (9.7% versus 1.8%, p = 0.02). A pacemaker was implanted in 20 (9%) cases, while 28 (12%) patients experienced an acute kidney injury. There was a general trend towards temporal improvements in complication rates across the years.
Conclusions: The TAVI caseload has risen significantly in our centre in recent years. Overall, peri-procedural complication rates have been low and device success rates high, consistent with international registry data. There have been temporal improvements in the majority of TAVI-related complications and length of hospital stay with increasing operator experience.
Keywords: Aortic stenosis; TAVI; TAVR; Valvular heart disease.
© 2025. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
Conflict of interest statement
Declarations. Ethics approval: This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Joint Research Ethics Committee of St. James’ Hospital and Tallaght University Hospital approved this study. Conflict of interest: The authors declare no competing interests.
Similar articles
-
Transcatheter Versus Surgical Approach for the Treatment of Aortic Stenosis in Patients With Concomitant Coronary Artery Disease: A Systematic Review and Meta-Analysis.Catheter Cardiovasc Interv. 2025 Jul 1. doi: 10.1002/ccd.31697. Online ahead of print. Catheter Cardiovasc Interv. 2025. PMID: 40590217 Review.
-
Transcatheter aortic valve implantation for aortic stenosis in high surgical risk patients: A systematic review and meta-analysis.PLoS One. 2018 May 10;13(5):e0196877. doi: 10.1371/journal.pone.0196877. eCollection 2018. PLoS One. 2018. PMID: 29746546 Free PMC article.
-
Meta-analysis of longitudinal comparison of transcatheter versus surgical aortic valve replacement in patients at low to intermediate surgical risk.Int J Surg. 2024 Dec 1;110(12):8097-8106. doi: 10.1097/JS9.0000000000002158. Int J Surg. 2024. PMID: 39806748 Free PMC article.
-
Transcatheter aortic valve implantation: evidence on safety and efficacy compared with medical therapy. A systematic review of current literature.Clin Res Cardiol. 2011 Apr;100(4):265-76. doi: 10.1007/s00392-010-0268-x. Epub 2010 Dec 17. Clin Res Cardiol. 2011. PMID: 21165626
-
Outcomes of transcatheter aortic valve implantation for native aortic valve regurgitation.EuroIntervention. 2024 Sep 2;20(17):e1076-e1085. doi: 10.4244/EIJ-D-24-00339. EuroIntervention. 2024. PMID: 39219361
References
-
- Ambrosy AP, Go AS, Leong TK et al (2023) Temporal trends in the prevalence and severity of aortic stenosis within a contemporary and diverse community-based cohort. Int J Cardiol 384:107–111. https://doi.org/10.1016/j.ijcard.2023.04.047 - DOI - PubMed
-
- Varadarajan P, Kapoor N, Bansal RC, Pai RG (2006) Survival in elderly patients with severe aortic stenosis is dramatically improved by aortic valve replacement: results from a cohort of 277 patients aged > or =80 years. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg 30(5):722–727. https://doi.org/10.1016/j.ejcts.2006.07.028 - DOI
-
- Mack MJ, Leon MB, Thourani VH et al (2019) Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med 380(18):1695–1705. https://doi.org/10.1056/NEJMoa1814052 - DOI - PubMed
-
- Reardon MJ, Van Mieghem NM, Popma JJ et al (2017) Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med 376(14):1321–1331. https://doi.org/10.1056/NEJMoa1700456 - DOI - PubMed
-
- Vahanian A, Beyersdorf F, Praz F et al (2022) 2021 ESC/EACTS Guidelines for the management of valvular heart disease: developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 43(7):561–632. https://doi.org/10.1093/eurheartj/ehab395 - DOI - PubMed
LinkOut - more resources
Full Text Sources