Transcatheter Aortic Valve Implantation (TAVI) Outcomes In Ontario

Dennis T. Ko, D M Purdham, M K Natarajan, David A Henry, E A Cohen, C M Feindel, K J Kingsbury

Research output: Contribution to journalMeeting AbstractResearchpeer-review

Abstract

BACKGROUND: Transcatheter aortic valve implantation (TAVI)
has emerged as a treatment for many severe symptomatic aortic
stenosis patients who cannot tolerate conventional aortic valve
surgery. Although TAVI has been demonstrated in landmark
trials to be effective, it is uncertain whether these results can be
generalized to the real world because of the substantial differences in patients enrolled in clinical trials as compared to those
encountered in clinical practice. Accordingly, our main objective was to evaluate the clinical outcome of a population-based
cohort of patients undergoing TAVI in Ontario, Canada.
METHODS: We made use of the data from Canadian Cardiovascular Network of Ontario (CCN), which has assembled an ongoing
clinical TAVI registry including all procedures performed in the
province. These data were subsequently linked to the Canadian Institute for Hospital Information hospital discharge abstract database
and the Registered Persons Database to determine clinical outcomes.
RESULTS: Among the 293 patients undergoing TAVI procedures
and had at least one year of follow-up, their mean age was 82 years
and 48% of the patients were female. TAVI was performed via the
trans-femoral approach in 61% and the trans-apical approach in
39%. The average length of stay was 13 days and the rate of stroke
was 4.4% at 30 days and 6.1% at 1 year. The all-cause mortality
rate after TAVI was 7.5% at 30 days and 20.5% at 1 year. To put
these mortality rates into context, the mortality rate following
valve implantation in PARTNER B, which evaluated patients
who could not undergo conventional surgery was 6.4% at 30 days
and 30.7% at 1 year after randomization.
CONCLUSIONS: In this population-cohort of elderly patients undergoing TAVI procedures in Ontario, we found clinical outcomes that are comparable to those observed in clinical trials.
Original languageEnglish
Article number311
Pages (from-to)s2012
JournalCanadian Journal of Cardiology
Volume28
Issue number5
DOIs
Publication statusPublished - 2012
Externally publishedYes

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Ontario
Clinical Trials
Mortality
Transcatheter Aortic Valve Replacement
Random Allocation
Thigh
Population
Canada
Registries
Length of Stay
Databases

Cite this

Ko, D. T., Purdham, D. M., Natarajan, M. K., Henry, D. A., Cohen, E. A., Feindel, C. M., & Kingsbury, K. J. (2012). Transcatheter Aortic Valve Implantation (TAVI) Outcomes In Ontario. Canadian Journal of Cardiology, 28(5), s2012. [311]. https://doi.org/10.1016/j.cjca.2012.07.293
Ko, Dennis T. ; Purdham, D M ; Natarajan, M K ; Henry, David A ; Cohen, E A ; Feindel, C M ; Kingsbury, K J. / Transcatheter Aortic Valve Implantation (TAVI) Outcomes In Ontario. In: Canadian Journal of Cardiology. 2012 ; Vol. 28, No. 5. pp. s2012.
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abstract = "BACKGROUND: Transcatheter aortic valve implantation (TAVI)has emerged as a treatment for many severe symptomatic aorticstenosis patients who cannot tolerate conventional aortic valvesurgery. Although TAVI has been demonstrated in landmarktrials to be effective, it is uncertain whether these results can begeneralized to the real world because of the substantial differences in patients enrolled in clinical trials as compared to thoseencountered in clinical practice. Accordingly, our main objective was to evaluate the clinical outcome of a population-basedcohort of patients undergoing TAVI in Ontario, Canada.METHODS: We made use of the data from Canadian Cardiovascular Network of Ontario (CCN), which has assembled an ongoingclinical TAVI registry including all procedures performed in theprovince. These data were subsequently linked to the Canadian Institute for Hospital Information hospital discharge abstract databaseand the Registered Persons Database to determine clinical outcomes.RESULTS: Among the 293 patients undergoing TAVI proceduresand had at least one year of follow-up, their mean age was 82 yearsand 48{\%} of the patients were female. TAVI was performed via thetrans-femoral approach in 61{\%} and the trans-apical approach in39{\%}. The average length of stay was 13 days and the rate of strokewas 4.4{\%} at 30 days and 6.1{\%} at 1 year. The all-cause mortalityrate after TAVI was 7.5{\%} at 30 days and 20.5{\%} at 1 year. To putthese mortality rates into context, the mortality rate followingvalve implantation in PARTNER B, which evaluated patientswho could not undergo conventional surgery was 6.4{\%} at 30 daysand 30.7{\%} at 1 year after randomization.CONCLUSIONS: In this population-cohort of elderly patients undergoing TAVI procedures in Ontario, we found clinical outcomes that are comparable to those observed in clinical trials.",
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Ko, DT, Purdham, DM, Natarajan, MK, Henry, DA, Cohen, EA, Feindel, CM & Kingsbury, KJ 2012, 'Transcatheter Aortic Valve Implantation (TAVI) Outcomes In Ontario' Canadian Journal of Cardiology, vol. 28, no. 5, 311, pp. s2012. https://doi.org/10.1016/j.cjca.2012.07.293

Transcatheter Aortic Valve Implantation (TAVI) Outcomes In Ontario. / Ko, Dennis T.; Purdham, D M; Natarajan, M K; Henry, David A; Cohen, E A; Feindel, C M; Kingsbury, K J.

In: Canadian Journal of Cardiology, Vol. 28, No. 5, 311, 2012, p. s2012.

Research output: Contribution to journalMeeting AbstractResearchpeer-review

TY - JOUR

T1 - Transcatheter Aortic Valve Implantation (TAVI) Outcomes In Ontario

AU - Ko, Dennis T.

AU - Purdham, D M

AU - Natarajan, M K

AU - Henry, David A

AU - Cohen, E A

AU - Feindel, C M

AU - Kingsbury, K J

PY - 2012

Y1 - 2012

N2 - BACKGROUND: Transcatheter aortic valve implantation (TAVI)has emerged as a treatment for many severe symptomatic aorticstenosis patients who cannot tolerate conventional aortic valvesurgery. Although TAVI has been demonstrated in landmarktrials to be effective, it is uncertain whether these results can begeneralized to the real world because of the substantial differences in patients enrolled in clinical trials as compared to thoseencountered in clinical practice. Accordingly, our main objective was to evaluate the clinical outcome of a population-basedcohort of patients undergoing TAVI in Ontario, Canada.METHODS: We made use of the data from Canadian Cardiovascular Network of Ontario (CCN), which has assembled an ongoingclinical TAVI registry including all procedures performed in theprovince. These data were subsequently linked to the Canadian Institute for Hospital Information hospital discharge abstract databaseand the Registered Persons Database to determine clinical outcomes.RESULTS: Among the 293 patients undergoing TAVI proceduresand had at least one year of follow-up, their mean age was 82 yearsand 48% of the patients were female. TAVI was performed via thetrans-femoral approach in 61% and the trans-apical approach in39%. The average length of stay was 13 days and the rate of strokewas 4.4% at 30 days and 6.1% at 1 year. The all-cause mortalityrate after TAVI was 7.5% at 30 days and 20.5% at 1 year. To putthese mortality rates into context, the mortality rate followingvalve implantation in PARTNER B, which evaluated patientswho could not undergo conventional surgery was 6.4% at 30 daysand 30.7% at 1 year after randomization.CONCLUSIONS: In this population-cohort of elderly patients undergoing TAVI procedures in Ontario, we found clinical outcomes that are comparable to those observed in clinical trials.

AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI)has emerged as a treatment for many severe symptomatic aorticstenosis patients who cannot tolerate conventional aortic valvesurgery. Although TAVI has been demonstrated in landmarktrials to be effective, it is uncertain whether these results can begeneralized to the real world because of the substantial differences in patients enrolled in clinical trials as compared to thoseencountered in clinical practice. Accordingly, our main objective was to evaluate the clinical outcome of a population-basedcohort of patients undergoing TAVI in Ontario, Canada.METHODS: We made use of the data from Canadian Cardiovascular Network of Ontario (CCN), which has assembled an ongoingclinical TAVI registry including all procedures performed in theprovince. These data were subsequently linked to the Canadian Institute for Hospital Information hospital discharge abstract databaseand the Registered Persons Database to determine clinical outcomes.RESULTS: Among the 293 patients undergoing TAVI proceduresand had at least one year of follow-up, their mean age was 82 yearsand 48% of the patients were female. TAVI was performed via thetrans-femoral approach in 61% and the trans-apical approach in39%. The average length of stay was 13 days and the rate of strokewas 4.4% at 30 days and 6.1% at 1 year. The all-cause mortalityrate after TAVI was 7.5% at 30 days and 20.5% at 1 year. To putthese mortality rates into context, the mortality rate followingvalve implantation in PARTNER B, which evaluated patientswho could not undergo conventional surgery was 6.4% at 30 daysand 30.7% at 1 year after randomization.CONCLUSIONS: In this population-cohort of elderly patients undergoing TAVI procedures in Ontario, we found clinical outcomes that are comparable to those observed in clinical trials.

U2 - 10.1016/j.cjca.2012.07.293

DO - 10.1016/j.cjca.2012.07.293

M3 - Meeting Abstract

VL - 28

SP - s2012

JO - Canadian Journal of Cardiology

JF - Canadian Journal of Cardiology

SN - 0828-282X

IS - 5

M1 - 311

ER -