Patterns and trends of transcatheter aortic valve implantation in Italy: insights from RISPEVA

Arturo Giordano, Nicola Corcione, Giuseppe Biondi-Zoccai, Sergio Berti, Anna Sonia Petronio, Carlo Pierli, Patrizia Presbitero, Pietro Giudice, Gennaro Sardella, Antonio L. Bartorelli, Roberto Bonmassari, Ciro Indolfi, Alfredo Marchese, Elvis Brscic, Alberto Cremonesi, Luca Testa, Nedy Brambilla, Francesco Bedogni

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

AIMS: Clinical trials have shown that transcatheter aortic valve implantation for aortic stenosis compares favorably to surgical replacement in high-risk patients and is superior to medical therapy in those at prohibitive risk. There is uncertainty however on patterns and trends in transcatheter aortic valve implantation, especially focusing on Italy. METHODS: The RISPEVA study is a prospective Italian registry including 21 institutions. Patients have been enrolled since late 2012, and data collection includes several baseline, procedural, in-hospital, and follow-up details. For the present analysis on patterns and trends, we focused on patients enrolled between 2012 and 2015, and as primary variable on the prevalence of high versus prohibitive surgical risk, limiting our scope to procedural outcomes. RESULTS: A total of 1157 patients were included. The temporal breakdown was 376 (33%) patients enrolled in 2013, 408 (35%) in 2014, and 373 (32%) in 2015. Several patient features differed over time, including risk score, peripheral artery disease, end-stage pulmonary disease, and prior valvuloplasty (all P?<?0.05). Several procedural features differed significantly over time, including sheath size, use of general anesthesia, Prostar closure device, predilation, antiembolic device, new TAVI device, and multiple prostheses (all P?<?0.05). No significant temporal differences were found for major clinical outcomes, whereas the occurrence of moderate or severe postprocedural regurgitation and pacemaker dependency decreased over the years (both P?<?0.05). CONCLUSION: According to the RISPEVA results, the Italian uptake of TAVI is steady, with evident trends toward less invasive approaches and fitter patients.

Original languageEnglish
JournalJournal of Cardiovascular Medicine
DOIs
Publication statusAccepted/In press - Nov 24 2016

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Italy
Equipment and Supplies
Peripheral Arterial Disease
Aortic Valve Stenosis
Transcatheter Aortic Valve Replacement
General Anesthesia
Lung Diseases
Prostheses and Implants
Uncertainty
Registries
Clinical Trials

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Giordano, A., Corcione, N., Biondi-Zoccai, G., Berti, S., Petronio, A. S., Pierli, C., ... Bedogni, F. (Accepted/In press). Patterns and trends of transcatheter aortic valve implantation in Italy: insights from RISPEVA. Journal of Cardiovascular Medicine. https://doi.org/10.2459/JCM.0000000000000489

Patterns and trends of transcatheter aortic valve implantation in Italy : insights from RISPEVA. / Giordano, Arturo; Corcione, Nicola; Biondi-Zoccai, Giuseppe; Berti, Sergio; Petronio, Anna Sonia; Pierli, Carlo; Presbitero, Patrizia; Giudice, Pietro; Sardella, Gennaro; Bartorelli, Antonio L.; Bonmassari, Roberto; Indolfi, Ciro; Marchese, Alfredo; Brscic, Elvis; Cremonesi, Alberto; Testa, Luca; Brambilla, Nedy; Bedogni, Francesco.

In: Journal of Cardiovascular Medicine, 24.11.2016.

Research output: Contribution to journalArticle

Giordano, A, Corcione, N, Biondi-Zoccai, G, Berti, S, Petronio, AS, Pierli, C, Presbitero, P, Giudice, P, Sardella, G, Bartorelli, AL, Bonmassari, R, Indolfi, C, Marchese, A, Brscic, E, Cremonesi, A, Testa, L, Brambilla, N & Bedogni, F 2016, 'Patterns and trends of transcatheter aortic valve implantation in Italy: insights from RISPEVA', Journal of Cardiovascular Medicine. https://doi.org/10.2459/JCM.0000000000000489
Giordano, Arturo ; Corcione, Nicola ; Biondi-Zoccai, Giuseppe ; Berti, Sergio ; Petronio, Anna Sonia ; Pierli, Carlo ; Presbitero, Patrizia ; Giudice, Pietro ; Sardella, Gennaro ; Bartorelli, Antonio L. ; Bonmassari, Roberto ; Indolfi, Ciro ; Marchese, Alfredo ; Brscic, Elvis ; Cremonesi, Alberto ; Testa, Luca ; Brambilla, Nedy ; Bedogni, Francesco. / Patterns and trends of transcatheter aortic valve implantation in Italy : insights from RISPEVA. In: Journal of Cardiovascular Medicine. 2016.
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abstract = "AIMS: Clinical trials have shown that transcatheter aortic valve implantation for aortic stenosis compares favorably to surgical replacement in high-risk patients and is superior to medical therapy in those at prohibitive risk. There is uncertainty however on patterns and trends in transcatheter aortic valve implantation, especially focusing on Italy. METHODS: The RISPEVA study is a prospective Italian registry including 21 institutions. Patients have been enrolled since late 2012, and data collection includes several baseline, procedural, in-hospital, and follow-up details. For the present analysis on patterns and trends, we focused on patients enrolled between 2012 and 2015, and as primary variable on the prevalence of high versus prohibitive surgical risk, limiting our scope to procedural outcomes. RESULTS: A total of 1157 patients were included. The temporal breakdown was 376 (33{\%}) patients enrolled in 2013, 408 (35{\%}) in 2014, and 373 (32{\%}) in 2015. Several patient features differed over time, including risk score, peripheral artery disease, end-stage pulmonary disease, and prior valvuloplasty (all P?<?0.05). Several procedural features differed significantly over time, including sheath size, use of general anesthesia, Prostar closure device, predilation, antiembolic device, new TAVI device, and multiple prostheses (all P?<?0.05). No significant temporal differences were found for major clinical outcomes, whereas the occurrence of moderate or severe postprocedural regurgitation and pacemaker dependency decreased over the years (both P?<?0.05). CONCLUSION: According to the RISPEVA results, the Italian uptake of TAVI is steady, with evident trends toward less invasive approaches and fitter patients.",
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AU - Giordano, Arturo

AU - Corcione, Nicola

AU - Biondi-Zoccai, Giuseppe

AU - Berti, Sergio

AU - Petronio, Anna Sonia

AU - Pierli, Carlo

AU - Presbitero, Patrizia

AU - Giudice, Pietro

AU - Sardella, Gennaro

AU - Bartorelli, Antonio L.

AU - Bonmassari, Roberto

AU - Indolfi, Ciro

AU - Marchese, Alfredo

AU - Brscic, Elvis

AU - Cremonesi, Alberto

AU - Testa, Luca

AU - Brambilla, Nedy

AU - Bedogni, Francesco

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N2 - AIMS: Clinical trials have shown that transcatheter aortic valve implantation for aortic stenosis compares favorably to surgical replacement in high-risk patients and is superior to medical therapy in those at prohibitive risk. There is uncertainty however on patterns and trends in transcatheter aortic valve implantation, especially focusing on Italy. METHODS: The RISPEVA study is a prospective Italian registry including 21 institutions. Patients have been enrolled since late 2012, and data collection includes several baseline, procedural, in-hospital, and follow-up details. For the present analysis on patterns and trends, we focused on patients enrolled between 2012 and 2015, and as primary variable on the prevalence of high versus prohibitive surgical risk, limiting our scope to procedural outcomes. RESULTS: A total of 1157 patients were included. The temporal breakdown was 376 (33%) patients enrolled in 2013, 408 (35%) in 2014, and 373 (32%) in 2015. Several patient features differed over time, including risk score, peripheral artery disease, end-stage pulmonary disease, and prior valvuloplasty (all P?<?0.05). Several procedural features differed significantly over time, including sheath size, use of general anesthesia, Prostar closure device, predilation, antiembolic device, new TAVI device, and multiple prostheses (all P?<?0.05). No significant temporal differences were found for major clinical outcomes, whereas the occurrence of moderate or severe postprocedural regurgitation and pacemaker dependency decreased over the years (both P?<?0.05). CONCLUSION: According to the RISPEVA results, the Italian uptake of TAVI is steady, with evident trends toward less invasive approaches and fitter patients.

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