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Ábendingar og árangur ósoarlokuísetningar meo roingartkni (TAVI) á Íslandi

Ábendingar og árangur ósoarlokuísetningar meo roingartkni (TAVI) á Íslandi


Title: Ábendingar og árangur ósoarlokuísetningar meo roingartkni (TAVI) á Íslandi
Alternative Title: Indications and outcomes of TAVI (transcatheter aortic valve implantation) in Iceland
Author: Lárusdóttir, Katrín Júniána
Guðmundsson, Hjalti
Johnsen, Árni
Sigurðsson, Martin Ingi
Guðbjartsson, Tómas
Guomundsdóttir, Ingibjörg Jóna
Date: 2021-03
Language: Icelandic
Scope: 7
University/Institute: Landspítali
Department: Skurðstofur og gjörgæsla
Læknadeild
Hjarta- og æðaþjónusta
Series: Laeknabladid; 107(3)
ISSN: 0023-7213
DOI: https://doi.org/10.17992/lbl.2021.03.625
Subject: Aortic stenosis; Complications; Indications; Outcome; Survival; Transcatheter aortic valve implantation; Humans; Risk Factors; Male; Transcatheter Aortic Valve Replacement/adverse effects; Treatment Outcome; Aortic Valve Stenosis/diagnostic imaging; Heart Valve Prosthesis Implantation/adverse effects; Aged, 80 and over; Female; Aged; Iceland/epidemiology; Retrospective Studies; Aortic Valve/diagnostic imaging; Læknisfræði (allt)
URI: https://hdl.handle.net/20.500.11815/3111

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Citation:

Lárusdóttir , K J , Guðmundsson , H , Johnsen , Á , Sigurðsson , M I , Guðbjartsson , T & Guomundsdóttir , I J 2021 , ' Ábendingar og árangur ósoarlokuísetningar meo roingartkni (TAVI) á Íslandi ' , Laeknabladid , bind. 107 , nr. 3 , bls. 123-129 . https://doi.org/10.17992/lbl.2021.03.625

Abstract:

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 aorticvalve 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.

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