Læknablaðið - 01.03.2021, Blaðsíða 17

L ÆK N A BL AÐIÐ 2021/107 129
R A N N S Ó K N
E N G L I S H S U M M A R Y
Katrín Júníana Lárusdóttir1
Hjalti Guðmundsson2
Árni Johnsen3
Martin Ingi Sigurðsson1,4
Tómas Guðbjartsson1,3
Ingibjörg Jóna Guðmundsdóttir1,2
1Faculty of Medicine, University of Iceland, 2Department
of Cardiology, 3Cardiothoracic surgery, 4Anesthesia and
Intensive Care, Landspitali University Hospital, Reykjavik,
Iceland
Correspondence: Ingibjörg J. Guðmundsdóttir,
ig@landspitali.is
Key words: Transcatheter aortic valve implantation,
aortic stenosis, indications, outcome, complications,
survival.
Indications and outcomes of TAVI (transcatheter aortic valve implantation) in Iceland
INTRODUCTION: Surgical aortic valve replacement (SAVR) has been the standard of
treatment for aortic stenosis but transcatheter aortic valve implantation (TAVI) is increasingly
used as treatment in Iceland and elsewhere. Our objective was to assess the outcome of TAVI
in Iceland, focusing on indications, complications and survival.
MATERIAL AND METHODS: This retrospective study included all TAVI-procedures performed
in Iceland between January 2012 and June 2020. Patient characteristics, outcome and
complications were registered, and overall estimated survival compared to an age and sex
matched Icelandic reference-population. The mean follow-up was 2.4 years.
RESULTS: Altogether 189 TAVI procedures (mean age 83±6 years, 41.8% females), were
performed, all with a self-expanding biological valve. Most patients (81.5%) had symptoms of
severe heart failure (NYHA-class III-IV) and median EuroSCORE-II was 4.9 (range: 0.9-32).
Echocardiography pre-TAVI showed a mean aortic-valve area of 0.67 cm2 and a max aortic-
valve gradient of 78 mmHg. One out of four patients (26.5%) needed permanent pacemaker
implantation following TAVI. Other complications were mostly vascular-related (13.8%) but
cardiac cardiac temponade and stroke occurred in 3.2 and 2.6% of cases, respectively and
severe paravalvular aortic valve regurgitation in 0.5% cases. Thirty-day mortality was 1.6%
(n=3) with one-year survival of 93.5% (95% CI: 89.8-97.3). Finally long-term survival survival of
TAVI-patients was similar to the matched reference population (p=0.23).
CONCLUSIONS: The outcome of TAVI-procedures in Iceland is good, especially regarding
30-day mortality and long-term survival that was comparable to a reference population.
Incidence of major complications was also low.
doi 10.17992/lbl.2021.03.625
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