September 12, 2011Circulation
Transapical Aortic Valve Implantation
Key result
Recent experience with transapical aortic valve implantation significantly improved 1-year mortality compared to early experience (21.5% vs 30.7%, P=0.047), reflecting a significant learning curve.
Why the study?
Does increased institutional experience with transapical aortic valve implantation improve mortality outcomes in high-risk patients?
Population
299 high-risk patients undergoing transapical aortic valve implantation between February 2006 and January 2010
Comparison
Transapical aortic valve implantation with the… vs Early experience with the same procedure
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
Institutional experience may improve transapical TAVI survival; extends learning-curve observations but leaves causal effects open in randomized data.
Study Design
Type
Cohort (n=299)
Structured PICO
Does increased institutional experience with transapical aortic valve implantation improve mortality outcomes in high-risk patients?
P
Population
299 high-risk patients undergoing transapical aortic valve implantation between February 2006 and January 2010
I
Intervention
Transapical aortic valve implantation with the Edwards SAPIEN transcatheter prosthesis (Recent Experience group, patients 151 to 299)
C
Comparator
Early experience with the same procedure (Early Experience group, patients 1 to 150)
O
Outcome
30-day mortality and 1-year mortalityhard clinical
Main Result
Absolute Event Rate: 21.5% vs 30.7%
p-value: p=0.047
Increased institutional experience with transapical aortic valve implantation is associated with significantly improved 30-day and 1-year mortality despite a consistently high patient risk profile.
Cite This Study
Kempfert et al. (2011) conducted a cohort in High-risk patients requiring aortic valve implantation (n=299). Transapical aortic valve implantation (recent experience) vs. Early experience was evaluated on 1-year mortality (p=0.047). Recent experience with transapical aortic valve implantation significantly improved 1-year mortality compared to early experience (21.5% vs 30.7%, P=0.047), reflecting a significant learning curve.