Transcatheter Aortic Valve Implantation in Brazilian Public Health System: A Single-Center Experience.

Q3 Medicine

Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI:10.1097/HPC.0000000000000387

Guilherme Pinheiro Machado, Pedro Castilhos Crivelaro, Gustavo Neves de Araujo, Alan Pagnoncelli, Julia Carvalho da Silva, Camila Porto Cardoso, Wagner Tadeu Azeredo Azevedo, Rodrigo Petersen Saadi, Eduardo Keller Saadi, Orlando Wender, Marco Wainstein, Felipe Costa Fuchs

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引用次数: 0

Abstract

Background: Transcatheter aortic valve implantation (TAVI) has been established as the treatment of choice for severe aortic stenosis in high-risk patients as well as patients above 75 years old in all risk spectrums. Despite its worldwide adoption, implementation in lower-middle-income countries such as the Brazilian public health system (SUS, acronym in Portuguese) is incipient.

Objectives: This study aimed to evaluate TAVI exclusively within SUS patients.

Methods: This was a prospective cohort study in a public tertiary hospital in southern Brazil. All patients who underwent TAVI between 2018 and 2024 were included. The cohort was divided into 2 temporal periods: from July 2018 to December 2022 (n = 60) and January 2023 to October 2024 (n = 65). The clinical and procedural characteristics and in-hospital, as well as 1 year of outcomes, were evaluated according to Valve Academic Research Consortium-2 (VARC-2) criteria.

Results: During the study period, 125 patients underwent TAVI. The average age was 80 years (± 10), and 49.6% were male. The mean aortic valve area was 0.76 cm² and the mean gradient was 45 (±13) mm Hg. The mean STS predicted risk of mortality (STS-PROM) score was 4.6% (±3.6). Device success was achieved in 119 patients (95.2%). In-hospital mortality was 2 (1.6%). A new permanent pacemaker was required in 16 (12.8%). Demographic and clinical characteristics between the first and the second periods were similar.

Conclusions: The mortality and complications rate of TAVI performed within the scope of the Brazilian public health system were consistent with the clinical experience of other international registries.

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经导管主动脉瓣植入在巴西公共卫生系统：单一中心的经验。

背景：经导管主动脉瓣植入术（TAVI）已被确定为治疗重度主动脉瓣狭窄的高危人群以及75岁以上所有危险谱患者的首选方法。尽管它在世界范围内被采用，但在巴西公共卫生系统（SUS，葡萄牙语首字母缩略词）等中低收入国家的实施才刚刚开始。目的：本研究旨在专门评估SUS患者的TAVI。方法：在巴西南部一家公立三级医院进行前瞻性队列研究。所有在2018年至2024年间接受TAVI的患者都被纳入其中。该队列被分为两个时间段：2018年7月至2022年12月（n=60）和2023年1月至2024年10月（n=65）。根据瓣膜学术研究联盟-2 （VARC-2）标准评估临床和手术特征、住院和1年预后。结果：在研究期间，125例患者接受了TAVI。平均年龄80岁（±10岁），男性占49.6%。平均主动脉瓣面积为0.76 cm2，平均梯度为45（±13）mmHg。STS预测死亡风险（STS- prom）平均评分为4.6%（±3.6）。119例患者（95.2%）器械成功。住院死亡率为2（1.6%）。16例（12.8%）需要新的永久性起搏器。第一期和第二期的人口学和临床特征相似。结论：在巴西公共卫生系统范围内进行TAVI的死亡率和并发症发生率与其他国际登记的临床经验一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Pathways in Cardiology Medicine-Medicine (all)

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： Critical Pathways in Cardiology provides a single source for the diagnostic and therapeutic protocols in use at hospitals worldwide for patients with cardiac disorders. The Journal presents critical pathways for specific diagnoses—complete with evidence-based rationales—and also publishes studies of these protocols" effectiveness.