Early experience of transcatheter aortic valve implantation (TAVI) procedure in Isfahan, Iran.

Background: Valve replacement is an optional treatment for patients with severe aortic stenosis (AS) and is associated with a better prognosis and improved quality of life. However, surgical valve replacement may result in severe complications, especially in the elderly. Transcatheter aortic valve replacement (TAVR) for treating symptomatic aortic stenosis has expanded exponentially, becoming a therapeutic option for intermediate- and high-risk patients. To thoroughly examine and monitor its practices and improve outcomes, our TAVI center in Isfahan established a detailed registry as the primary center for the TAVI procedure.

Methods: This prospective study was conducted among all patients who underwent the TAVR procedure from September 2022 to December 2023 in Isfahan. Baseline characteristics (demographic, clinical, and procedural), 30-day outcomes, and one-year mortality data were collected.

Results: A total of 50 patients underwent the TAVI procedure in Isfahan during our registry. Of these, 56% were male, and the mean age was 77.8 ± 6.7 years. The mean calculated STS score was 5.6. Cardiac death occurred in 4 patients (8%), one (2%) experienced a major vascular complication, 5 (10%) required new pacemaker implantation, and acute kidney injury was observed in 14%. Fever/sepsis occurred in 16%, cardiac tamponade in 6%, one patient (2%) had moderate AI, two patients experienced coronary obstructions, and one suffered a major cerebrovascular accident. Additionally, 4 patients (8%) developed atrial fibrillation, 1 (2%) had ventricular tachycardia, and 6 (12%) experienced AV block.

Conclusion: We have shown good both 30-days outcome and one year mortality in our registry that could be a proper option in treating severe AS with comorbidities instead of surgical aortic valve replacement.