Key result
Over a 7-year period, increasing experience with transfemoral TAVI was associated with significantly decreased procedural time, hospital length of stay, and 30-day postoperative mortality.
Why the study?
Does increasing experience over a 7-year period with transfemoral TAVI improve postoperative vascular outcomes and procedural characteristics in patients with aortic stenosis?
Cohort (n=340)
No
Does increasing experience over a 7-year period with transfemoral TAVI improve postoperative vascular outcomes and procedural characteristics in patients with aortic stenosis?
A 7-year single-center experience demonstrates that increasing institutional volume and experience with transfemoral TAVI is associated with shorter procedural times, reduced hospital length of stay, and lower 30-day mortality, without an increase in major vascular complications.
Answers are grounded in this paper and cite their sources.
Supports accumulating TAVI experience for efficiency gains; extends observational volume-outcome data while leaving vascular safety effects unresolved.
Transcatheter aortic valve implantation (TAVI) has become a well-established alternative to open surgery to treat aortic stenosis. We describe our 7-year TAVI experience using transfemoral access and identity changes in surgical activity and evaluate its impact on postoperative vascular outcomes. Consecutive patients (N = 340) who underwent TAVI with percutaneous transfemoral access were retrospectively included and divided into 4 quartiles according to the date of intervention. Vascular outcomes were classified according to the Valve Academic Research Consortium 2 classification. The number of patients who underwent transfemoral TAVI increased over time and their clinical characteristics evolved, with a lower Society of Thoracic Surgeons score and less comorbidities. The material used evolved and TAVI could be performed despite higher iliac calcification and tortuosity scores. With experience, the procedural time, the postoperative length of stay at hospital, and the 30-day postoperative mortality significantly decreased. No significant change was observed for vascular outcome, except for minor hematoma. We witnessed an increase in transfemoral TAVI procedure, with changes in clinical and procedural characteristics associated with an improvement in postoperative outcomes.
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Lareyre et al. (2017) conducted a cohort in Aortic stenosis (n=340). Transfemoral TAVI experience over time vs. Earlier experience quartiles was evaluated on Postoperative vascular outcomes and 30-day postoperative mortality. Over a 7-year period, increasing experience with transfemoral TAVI was associated with significantly decreased procedural time, hospital length of stay, and 30-day postoperative mortality.
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