Brazilian Registry Evaluates Outcomes and Predictors of Mortality in TAVI

January 13, 2015—Findings from the Brazilian registry study that sought to evaluate outcomes and predictors of mortality after transcatheter aortic valve implantation (TAVI) were published by Fábio S. de Brito, Jr, MD, et al online ahead of print in Catheterization and Cardiovascular Interventions. All endpoints and complications were analyzed according to Valve Academic Research Consortium-2 criteria, noted the investigators.

This multicenter registry reflected a real-life national TAVI experience. Comorbidities, periprocedural complications, and moderate/severe paravalvular regurgitation (PVR) were associated with increased mortality, and the use of transesophageal echocardiogram to monitor the procedure acted as a protective factor against overall and late mortality.

A summarized in Catheterization and Cardiovascular Interventions, the Brazilian registry included 418 patients who underwent TAVI in 18 centers between January 2008 and January 2013. The transfemoral approach was used in 96.2% of the procedures. The CoreValve (Medtronic, Inc.) and Sapien XT (Edwards Lifesciences Corporation) prosthesis were used in 360 (86.1%) and 58 (13.9%) cases, respectively. All-cause mortality was 9.1% at 30 days and 21.5% at 1 year.

The study found that independent predictors of overall mortality included chronic obstructive pulmonary disease (COPD), acute kidney injury (AKI), stroke, and moderate/severe PVR. COPD, major vascular complications, and device malpositioning were predictors of early (≤ 30 days) mortality, whereas COPD, NYHA class III/IV, stroke, AKI, and moderate/severe PVR impacted late (> 30 days) mortality, reported the investigators in Catheterization and Cardiovascular Interventions.