Presentation is loading. Please wait.

Presentation is loading. Please wait.

Transcatheter aortic valve implantation. Brazilian reality and perspectives! Fábio S. Brito Jr., MD, PhD Hospital Israelita Albert Einstein São Paulo,

Similar presentations


Presentation on theme: "Transcatheter aortic valve implantation. Brazilian reality and perspectives! Fábio S. Brito Jr., MD, PhD Hospital Israelita Albert Einstein São Paulo,"— Presentation transcript:

1 Transcatheter aortic valve implantation. Brazilian reality and perspectives! Fábio S. Brito Jr., MD, PhD Hospital Israelita Albert Einstein São Paulo, Brazil On behalf of the SBHCI TAVI Registry investigators

2 > 75 years: 1,421, years: 5,027,000 Life Expectancy: 73,5 years Population: 190,000,000 > 75 years: 11,064,000 Brazil: Population Pyramid by Age and Gender

3 Sapien-EdwardsCoreValve-MedtronicInovare-Braile Approval Sept cases: 37 TF 05 TA Approval Jan cases: 395 TF 10 Subclavian 05 TransAo Approval Sept cases: 157 TA 01 Tao 08 TF TAVR in Brazil: 618 cases (Jan/ July 2012)

4 Numbers of TAVR in Brazil (Corevalve + Sapien) Numbers of TAVR in Brazil (Corevalve + Sapien)

5 Brazilian TAVI Registry Real World Registry. Real World Registry. Electronic Monitoring: 100% Electronic Monitoring: 100% Adverse Events Committee: Mortality Adverse Events Committee: Mortality Endpoints and Complications in acordance with Valve Academic Research Consortium Consensus on Event Definition Endpoints and Complications in acordance with Valve Academic Research Consortium Consensus on Event Definition CoreValve and Sapien cases. CoreValve and Sapien cases.

6 TAVI Registry: Inclusion SBHCI TAVI Registry: 50% of all cases in Brazil and 66% of all CoreValve / Sapien

7 85% em 5 centros Inclusion / Center

8 Characteristics (n = 277) Age, years 81.7 (DP 7.6) Male, n (%) 132 (47.6%) Logistic EuroScore I, % 20.7 (DP 14.2) STS Score, % 14.2 (DP 13.2) Congestive Heart Failure (NYHA) I or II, n (%) I or II, n (%) 50 (18.1 %) III or IV, n (%) III or IV, n (%) 227 (81.9 %) Diabetes, n (%) 84 (30.3 %) Renal Failure, n (%)* 216 (77.9 %) Brazilian TAVI Registry: Baseline Characteristics * GFR<60ml/min

9 (n = 277) Access Femoral, n (%) 268 (96.7 %) Subclavian, n (%) 8 (2.8 %) Other, n (%) 1 (0.3%) Valvuloplasty, n (%) 168 (69.1 %) Valve-in-valve 6 (2,1 %) Bioprosthesis Corevalve, n (%) 250 (90.2 %) Sapien XT, n (%) 27 (9.8 %) Post dilatation, n (%) 94 (33.9 %) Device Success, n (%) 241 (87 %) Device Failure, n (%) 35 (13%) Mod/Sev aortic regurgitation 16 (5.7%) 2nd device 15 (5.4%) Other cause 7 (2.5%) Brazilian TAVI Registry: Procedure Characteristics

10 Brazilian TAVI Registry: Echo Results p=ns p<0.001

11 ICC (NYHA) I or II, n (%) I or II, n (%) 50 (18.1 %) III or IV, n (%) III or IV, n (%) 227 (81.9 %) ICC (NYHA) I or II, n (%) I or II, n (%) 218 (94.7%) III or IV, n (%) III or IV, n (%) 12 (5.3 %) Brazilian TAVI Registry: 30 Days Results Baseline (277 pts): 30 days (230 pts):

12 n=277 Mortality, n (%) 27 (9.7 %) Cardiovascular Mortality, n (%) 22 (7.9 %) Myocardial Infarction 1 (0.4 %) Stoke 12 (4.3 %) Bleeding, n (%) 43 (15.5 %) Life-threatening, n (%) 13 (4.6 %) Major, n (%) 18 (6.4 %) Minor, n (%) 12 (4.3 %) Vascular Complication, n (%) 28 (10.1 %) Major, n (%) 15 (5.4 %) Minor, n (%) 13 (4.6 %) Pacemaker, n (%) 51 (21.5 %) CoreValve, n (%) 51 (24.1%) Sapien, n (%) 0 Brazilian TAVI Registry: 30 Days Results

13 CoreValve Registries: 30-Day All-Cause Mortality 1.Medtronic Data on File. COR : 18 Fr Safety & Efficacy Study Re-Analysis, August 14, Meredith. VARC-adjudicated Outcomes in Inoperable and High Risk AS Patients. TCT 2010, Washington, DC. 3.Avanzas P, Munoz-Garcia AJ, Segura J, et al. Percutaneous implantation of the CoreValve ® self-expanding aortic valve prosthesis in patients with severe aortic stenosis: early experience in Spain. Rev Esp Cardiol. 2010;63: Eltchaninoff. French Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 5.Bosmans. Belgian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 6.Zahn. German Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 7.Ludman. UK Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 8.Petronio. Italian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 15.2% 5.6% 7.4% 15.1% 9.0% 12.4% 5.5% 7.2% 0% 5% 10% 15% 20% 25% 18 Fr S&E 1 ANZ 2 Spain 3 French 4 Belgian 5 German 6 UK 7 Italian 8 % Brazilian 9.7%

14 COREVALVE REGISTRIES: 30-Day Stroke Rate 9.6% 0% 5% 10% 15% 20% 18 Fr S&EFrenchBelgianGermanUKItalian 4.5% 4.0% 2.6% 4.0% 1.7% ANZ 1.9% Brazilian 4.3% ADVANCE 2.9%

15 COREVALVE REGISTRIES: Pacemaker Implantation 35.2% 26.9% 23% 42.5% 26% 18.5% 31.3% 40.0% 0% 10% 20% 30% 40% 50% 60% 18 Fr S&E ANZ Spain 1 French 2 Belgian 2 German 2 UK 2 Italian 2 Percent of Patients (%) Weighted Average 28.5% Brazilian 24% ADVANCE 26.3%

16 Transcatheter aortic valve implantation. Brazilian reality and perspectives! Thank you!!!!!


Download ppt "Transcatheter aortic valve implantation. Brazilian reality and perspectives! Fábio S. Brito Jr., MD, PhD Hospital Israelita Albert Einstein São Paulo,"

Similar presentations


Ads by Google