774 30-day Safety and Effectiveness for Transcatheter Aortic Valve Implantation in a Regional Australian Centre

Abstract

In the last 5 years, Australia has seen an exponential growth in the number of patients undergoing transcatheter aortic valve implantation (TAVI). Gold coast Hospital is a tertiary teaching regional hospital, which started TAVI service 2 years ago. In the current study we analysed the 30-day outcomes of the first 51 patients and compared it with the landmark Partner 2 trial. A prospective cohort analysis was performed on the first consecutive 51 patients who underwent TAVI (30 balloon-expandable and 21 self-expandable/ 3 subclavian and 48 femoral) at the GCUH and had completed 30 day clinical and imaging follow-up. Clinical characteristics and 30-day outcomes were compared with the landmark Partner 2 trial. Univariate analysis was performed to compare outcomes with the Partner 2 TAVI cohort. The average age of the patients was 82.2±7.3 years with 60% men. Two patients underwent emergency TAVI. The average STS score of 6.4±5.3 was slightly higher than the Partner 2 TAVI cohort (p=0.07). All patients had a successful TAVI as per the VARC definition with zero 30-day mortality. There was a significant improvement in the echo parameters at 30 days with only 4% of patients showing moderate + PVL. Only one vascular complication of pseudoaneurysm was noted. Other than the higher PPM rate most of the 30-day outcomes were similar or even better than Partner 2 TAVI cohort as shown in the figure 1. A successful TAVI program can be established in a regional centre by careful selection of patients.