Arq. Bras. Cardiol. 2024; 121(5): e20230551
In-Hospital Outcomes in the Brazilian Registry of Transcatheter Aortic Valve Implantation – 14-Year Analysis
Maria Cristina Meira Ferreira
, Viviana de Mello Guzzo Lemke
, Maria Sanali Moura de Oliveira Paiva
, Emilia Matos do Nascimento
, Basílio de Bragança Pereira
, Gláucia Maria Moraes de Oliveira
Introduction
Degenerative aortic stenosis, which currently afects 2% to 5% of adults over 65 years of age, has become a public health problem worldwide in recent decades. In Brazil, the prevalence of calcific aortic valve disease increased by 201.8% from 1990 to 2019, reflecting population aging.Transcatheter aortic valve implantation (TAVI) has appeared as an option to reduce mortality in patients with aortic stenosis in whom surgery would be difficult or risky.– Although several clinical studies have played an important role in the TAVI procedure evolution, a recent publication by Barili et al., analysing 8 randomized clinical trials on TAVI versus surgical aortic valve replacement, has identified the occcurrence of several biases with a systematic selective imbalance, favoring TAVI, such as deviation from random assigned treatment and loss to follow-up 6.7 times and 2.5 times smaller, respectively, in the TAVI group, while additional treatments during the procedure were 3.7 times more frequent in the surgical group.
Aiming to assess and monitor the use of TAVI, several nationally-representative registries have been implemented in several countries, showing higher rates of mortality and of non-fatal complications as compared to those reported in clinical trials. To better understand the results of the use of the TAVI technology in Brazil, the Brazilian Association of Interventional Cardiology (SBHCI) has implemented a registry of patients submitted to TAVI in Brazil, known as the Brazilian Registry of Transcatheter Aortic Valve Implantation and New Technologies (RIBAC-NT), which compiles data from patients undergoing TAVI since 2008.
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