Transcatheter Aortic Valve Implantation in the UK: Temporal Trends, Predictors of Outcome and 6 Year Follow Up: A Report from the UK TAVI Registry 2007 to 2012

This manuscript reports on data from the UK registry from 2007 to 2012 including 3980 TAVI procedures and a 6 year follow up. The authors carry out a good analysis of trends, risk factors for mortality and results. They found little change in the characteristics of patients treated in the UK by TAVI from 2007 to 2012. Pre-procedural atrial fibrillation was strongly associated with later mortality. Patients who could be treated by the femoral route had a lower mortality than those for whom an alternative route was needed. Unadjusted survival for the direct aortic and the transapical approach were similar at 1 to 2 years. Surgical femoral approaches were used in about 11% in 2007 to 2009, but in later years it increased to about 20%. No difference in outcomes was identified according to need for pacing, or the presence of pre-procedural LBBB. The presence of post procedural aortic regurgitation (moderate or severe) was associated with lower long term survival on multivariate analysis at 1 and 2 years. There was a low incidence of procedural stroke, but it had the strongest independent association with early and late mortality.