Key result
In transfemoral TAVI, case sequence number predicted mid-term mortality for both balloon-expandable (AUC 0.730) and self-expandable (AUC 0.625) devices, with a longer learning curve for SE devices.
Why the study?
Guidelines make no specific recommendation on device selection between BE and SE prostheses, and operator experience with each design might influence patient outcomes.
Does the learning curve (case sequence number) influence clinical outcomes differently in balloon-expandable versus self-expandable transfemoral TAVI?
Cohort (n=256)
No
Does the learning curve (case sequence number) influence clinical outcomes differently in balloon-expandable versus self-expandable transfemoral TAVI?
p-value: p=0.11
The learning curve for transfemoral TAVI impacts mid-term mortality regardless of prosthesis type, but achieving optimal outcomes requires a longer learning curve for self-expandable devices (≤85 procedures) compared to balloon-expandable devices (≤58 procedures).
No takes yet. Share an insight, caveat, or question.
Operator experience may affect TAVI outcomes by device type; challenges guideline neutrality and warrants dedicated RCTs.
Istrate et al. (2023) conducted a cohort in Transfemoral transcatheter aortic valve implantation (TAVI) (n=256). Balloon-expandable TAVI vs. Self-expandable TAVI was evaluated on Mid-term all-cause mortality predicted by case sequence number (p=0.11). In transfemoral TAVI, case sequence number predicted mid-term mortality for both balloon-expandable (AUC 0.730) and self-expandable (AUC 0.625) devices, with a longer learning curve for SE devices.
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