7-Year experience of transcatheter aortic valve implants (TAVI) in a Western Cape private healthcare setting

  • Hellmuth Weich Division of Cardiology Tygerberg Hospital / Faculty of Medicine & Health Sciences Stellenbosch University
  • Jacques Liebenberg Division of Cardiology Tygerberg Hospital / Faculty of Medicine & Health Sciences Stellenbosch University
  • Jacques Van Wyk Private Practice Mediclinic Panorama
  • Rocco Vivier Private Practice Mediclinic Panorama
  • Barry Barnard Private Practice Mediclinic Vergelegen
  • Mark Abelson Private Practice Mediclinic Vergelegen
  • Andre Phillips Private Practice Mediclinic Vergelegen
  • Tom Mabin Private Practice Mediclinic Vergelegen

Abstract

Introduction: We describe the largest South African transcatheter aortic valve implantation (TAVI) outcome report of a single team in the Western Cape, over a 7-year period from 2009 - 2016.

Methods: All patients who received TAVI at Mediclinic Vergelegen and Mediclinic Panorama were prospectively entered into a database. A total of 244 implants (61 CoreValve and 183 Edwards valves) were performed.

Results: Patients were high risk with a mean STS score of 7.89 (standard deviation (SD) 5.7) and mean logistic EuroSCORE of 26.5 (SD 12.5). There was a trend toward lower risk over time. Procedures were initially performed mainly via a transapical approach, but this changed to mostly transfemoral with the introduction of smaller delivery systems. Procedural success rate was 91.8% for CoreValve and 88.5% for Edwards cases. Mean length of hospital stay following TAVI was 9 days initially, but this declined to 4 days for the latter part of our experience. One year mortality was 19% and one year stroke rate was 10%.

Conclusion: Despite the limitations of a study of this nature, our group could document outcomes similar to international studies, with improvements over time and illustrating successful cooperation between different hospitals to expand exposure and experience in a resource-constrained environment.

Published
2019-04-23
Section
Articles