Temporal trends in TAVI outcomes: experience from an Irish tertiary referral centre.

Background: Transcatheter aortic valve implantation (TAVI) has become a well-established therapeutic option for severe aortic stenosis in recent decades. There is limited data published about Irish experiences with TAVI.

Aims: To characterize contemporary TAVI outcomes from an Irish tertiary referral centre.

Methods: A retrospective registry was created which included data on consecutive patients who underwent TAVI in our centre over a 3-year period. The Valve Academic Research Consortium 3 guideline was used to define endpoint definitions.

Results: A total of 230 TAVI procedures were performed; 62 (2019), 57 (2020) and 111 (2021). Cumulative mean age was 81 years, with a male majority (65%). Median hospital length-of-stay was lower in 2021 versus 2019 [3 days (IQR 2 to 10) versus 9 days (IQR 4-22), p = 0.008]. Of patients with at least 30-day follow-up data (95.3%), none experienced procedural or 30-day mortality. Cumulative all-cause mortality was 22% over a median follow-up of 491 days (IQR 323 to 780). The incidence of in-hospital cerebro-vascular accidents was higher in 2019 versus 2021 (9.7% versus 1.8%, p = 0.02). A pacemaker was implanted in 20 (9%) cases, while 28 (12%) patients experienced an acute kidney injury. There was a general trend towards temporal improvements in complication rates across the years.

Conclusions: The TAVI caseload has risen significantly in our centre in recent years. Overall, peri-procedural complication rates have been low and device success rates high, consistent with international registry data. There have been temporal improvements in the majority of TAVI-related complications and length of hospital stay with increasing operator experience.