{"id":12673,"date":"2011-10-19T19:52:20","date_gmt":"2011-10-19T23:52:20","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=12673"},"modified":"2011-10-19T19:53:19","modified_gmt":"2011-10-19T23:53:19","slug":"u-k-registry-tracks-long-term-tavi-outcomes","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/10\/19\/u-k-registry-tracks-long-term-tavi-outcomes\/","title":{"rendered":"U.K. Registry Tracks Long-Term TAVI Outcomes"},"content":{"rendered":"<p>The excitement over transcatheter aortic valve implantation (TAVI) has been tempered by the absence of long-term outcomes data and concerns that the procedure may not live up to its initial promise in real-world settings. Now a report from the U.K. TAVI Registry, which keeps track of every TAVI procedure performed in the U.K., sheds new light on the long-term outcomes of TAVI in real-world settings.<\/p>\n<p>In\u00a0<a href=\"http:\/\/content.onlinejacc.org\/cgi\/content\/abstract\/j.jacc.2011.08.050v1\">a paper published in the\u00a0<em>Journal of the American College of Cardiology<\/em><\/a>, Neil Moat and colleagues report the results of 877 TAVI procedures performed through 2009\u00a0in 870 high-risk patients at 25 centers (with a median of 24 implants per center). Mortality was ascertained in all patients:<\/p>\n<ul>\n<li>30-day survival: 92.9%<\/li>\n<li>1-year survival: 78.6%<\/li>\n<li>2-year survival: 73.7%<\/li>\n<\/ul>\n<div>\n<p>Mortality was higher in patients who received a nontransfemoral implant. Independent predictors of mortality were LVEF &lt;30, the presence of moderate or severe aortic regurgitation, and COPD.\u00a0At 30 days, the rate of stroke was 4.1% and the rate of MI was 1.3%.<\/p>\n<p>The authors conclude that \u201calthough 30-day mortality was acceptable, there was a significant attrition between 30 days and 12 months, predominantly in the highest risk cohort.\u201d The results support a randomized trial comparing TAVI to surgery in a less high-risk group of patients, they say.<\/p>\n<p>In\u00a0<a href=\"http:\/\/content.onlinejacc.org\/cgi\/content\/full\/j.jacc.2011.09.019v1\">an accompanying editorial<\/a>, Alec Vahanian, Dominique Himbert, and Bernard Iung write that the registry supports the use of TAVI in \u201chigh-risk or inoperable\u00a0patients, when performed in properly trained centers.\u201d Future efforts, they add, \u201cshould aim at improving patient selection both by a dedicated medicosurgical team and by improving procedural performance through careful training and improvement in technology.&#8221;<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The excitement over transcatheter aortic valve implantation (TAVI) has been tempered by the absence of long-term outcomes data and concerns that the procedure may not live up to its initial promise in real-world settings. Now a report from the U.K. TAVI Registry, which keeps track of every TAVI procedure performed in the U.K., sheds new [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20,9],"tags":[423,770,397],"class_list":["post-12673","post","type-post","status-publish","format-standard","hentry","category-cardiac-surgery","category-interventional-cardiology","tag-tavi","tag-tavr","tag-transcatheter-valve-therapy"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/12673","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=12673"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/12673\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=12673"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=12673"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=12673"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}