Transcatheter XXXX (TAVI) in Germany 2008-2014: on its way to standard therapy for @entity472 in the elderly?

@entity1 @entity1563 @entity886 @entity397 @entity472 @entity1580
AIMS: In Germany, all transcatheter aortic valve implantations (TAVI) and surgical @entity886 (sAVR) are registered within an obligatory quality assurance programme led by the independent AQUA Institute. We have summarised @entity1 and procedural characteristics, complication and mortality rates as reported in the annual, German language AQUA quality reports, freely accessible online, in order to provide a comprehensive overview of developments between 2008 and 2014. METHODS AND RESULTS: Since 2008, a total of 71,927 isolated sAVR and 48,353 TAVI procedures have been performed in Germany. The numbers of sAVR are steadily declining (2008: 11,205; 2014: 9,953). For TAVI, there has been a 20-fold increase since 2008, from 637 to 13,264 procedures in 2014, surpassing the annual numbers of isolated sAVR since 2013. The age profile of TAVI @entity1 has remained unchanged over time (mean age: 80.9 years), with a recent trend towards lower-risk/intermediate-risk @entity1 . TAVI complications are rapidly decreasing (2012: 9.4%; 2014: 3.9%); @entity397 , @entity1580 and @entity1563 are rare (<0.3%), with fewer @entity1 requiring surgical conversion to sternotomy (2012: 1.2%; 2014: 0.6%). In-hospital mortality after TAVI has halved in 2014 (4.2%) compared with 2008 (10.4%). CONCLUSIONS: Real-world clinical data from the obligatory quality assurance programme document the rapid adoption of TAVI in Germany, shifting treatment of @entity472 in the elderly from surgery to a catheter-based approach. Since 2008, similar to what happened with PCIs, complications of TAVI have declined considerably along with the need for emergency cardiac surgery. Most importantly, in-hospital mortality has halved from 2008 to 2014, while mortality for sAVR has remained unchanged.
