December 23, 2010European Journal of Cardio-Thoracic Surgery
The SOURCE Registry: what is the learning curve in trans-apical aortic valve implantation?
Key result
Trans-apical aortic valve implantation in the second year of commercialization showed reduced intraprocedural complications but no significant difference in 30-day mortality (10.7% vs 10.8%, p=ns).
Why the study?
Does increased experience over time improve 30-day mortality and procedural complications in patients undergoing trans-apical aortic valve implantation?
Population
1394 patients undergoing trans-apical aortic valve implantation at European centers, comparing Cohort 1 and…
Comparison
Trans-apical aortic valve implantation performed… vs Trans-apical aortic valve implantation performed…
Design
Cohort
Follow-up
30 days
Authors
Discussion
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Member takes
Implication
Highlights the critical impact of operator experience on early TA-AVI outcomes; leaves open.
Study Design
Type
Cohort (n=1,394)
Multicenter
Yes
Structured PICO
Does increased experience over time improve 30-day mortality and procedural complications in patients undergoing trans-apical aortic valve implantation?
P
Population
1,394 patients undergoing trans-apical aortic valve implantation at European centers, compared across two consecutive years to assess the learning curve and 30-day outcomes.
E
Exposure
Trans-apical aortic valve implantation (TA-AVI) performed in Cohort 2 (February 2009 - January 2010)
C
Comparator
Trans-apical aortic valve implantation (TA-AVI) performed in Cohort 1 (January 2008 - January 2009)
O
Outcome
30-day mortality and procedural complicationshard clinical
Main Result
Absolute Event Rate: 10.7% vs 10.8%
p-value: p=ns
Although the learning curve for trans-apical aortic valve implantation led to fewer intraprocedural technical complications, 30-day mortality remained unchanged, likely due to high baseline patient comorbidities.
Limitations
- Patient co-morbidities not captured by preoperative risk variables
Cite This Study
Wendler et al. (2010) conducted a cohort in Aortic valve disease requiring TA-AVI (n=1,394). Trans-apical aortic valve implantation (TA-AVI) in Year 2 (COHORT 2) vs. TA-AVI in Year 1 (COHORT 1) was evaluated on 30-day mortality (p=ns). Trans-apical aortic valve implantation in the second year of commercialization showed reduced intraprocedural complications but no significant difference in 30-day mortality (10.7% vs 10.8%, p=ns).