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

A. Giordano, N. Corcione, G. Biondi-Zoccai, S. Berti, A.S. Petronio, C. Pierli, P. Presbitero, P. Giudice, G. Sardella, A.L. Bartorelli, R. Bonmassari, C. Indolfi, A. Marchese, E. Brscic, A. Cremonesi, L. Testa, N. Brambilla, F. Bedogni

Research output: Contribution to journalArticle

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. © 2017 Italian Federation of Cardiology. All rights reserved.
Original languageEnglish
Pages (from-to)96-102
Number of pages7
JournalJournal of Cardiovascular Medicine
Volume18
Issue number2
DOIs
Publication statusPublished - 2017

Keywords

  • Aortic regurgitation
  • Aortic stenosis
  • Italy
  • Registry
  • Transcatheter aortic valve implantation
  • aorta valve prosthesis
  • aorta valve regurgitation
  • Article
  • artificial heart pacemaker
  • clinical outcome
  • disease registry
  • disease severity
  • follow up
  • general anesthesia
  • health care utilization
  • high risk patient
  • human
  • lung disease
  • multicenter study (topic)
  • parameters
  • patient history of surgery
  • peripheral occlusive artery disease
  • prevalence
  • prospective study
  • risk assessment
  • sheath size
  • surgical risk
  • transcatheter aortic valve implantation
  • trend study
  • valvuloplasty
  • vascular closure device
  • aged
  • aorta valve
  • Aortic Valve Stenosis
  • clinical trial
  • comorbidity
  • female
  • male
  • multicenter study
  • register
  • risk factor
  • severity of illness index
  • statistics and numerical data
  • treatment outcome
  • trends
  • very elderly
  • Aged
  • Aged, 80 and over
  • Aortic Valve
  • Comorbidity
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Registries
  • Risk Factors
  • Severity of Illness Index
  • Transcatheter Aortic Valve Replacement
  • Treatment Outcome

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    Giordano, A., Corcione, N., Biondi-Zoccai, G., Berti, S., Petronio, A. S., Pierli, C., Presbitero, P., Giudice, P., Sardella, G., Bartorelli, A. L., Bonmassari, R., Indolfi, C., Marchese, A., Brscic, E., Cremonesi, A., Testa, L., Brambilla, N., & Bedogni, F. (2017). Patterns and trends of transcatheter aortic valve implantation in Italy: Insights from RISPEVA. Journal of Cardiovascular Medicine, 18(2), 96-102. https://doi.org/10.2459/JCM.0000000000000489