title: The Ibero-American transcatheter aortic valve implantation registry with the CoreValve prosthesis. Early and long-term results.
abstract: BACKGROUND
  Transcatheter aortic valve implantation (TAVI) is the recommended therapy for patients with severe aortic stenosis who are not suitable candidates for surgery. The aim of this study was to describe early experience and long-term follow-up with the CoreValve self-expanding aortic prosthesis at 42 Ibero-American hospitals.
  
  
  METHODS
  Multiple centre observational study including 1220 consecutive patients with symptomatic severe aortic stenosis who are not suitable candidates for surgery and underwent transcatheter aortic valve implantation with the self-expanding Medtronic CoreValve System between December 2007 and May 2012.
  
  
  RESULTS
  The registry included 1220 consecutive patients with a mean age of 80.8 ± 6.3 years and a mean logistic euroSCORE of 17.8% ± 13%. The procedural success rate was 96.1%. Hospital mortality was 7.3% and combined end-point was 21.3%. Aortic regurgitation after TAVI was present in 24.5% (Sellers grade ≥ 2). The estimated 1-year and 2-year survival rates were 82.1% and 73.4% respectively. The following issues were significant independent risk factors for hospital mortality: acute kidney failure (odds ratio 3.55); stroke (odds ratio 5.72); major bleeding (odds ratio 2.64) and euroSCORE (odds ratio 1.02). Long-term predictors of mortality were diabetes mellitus (hazard ratio 1.59, 95% confidence interval 1.09-2.31), severe chronic obstructive pulmonary disease (hazard ratio 1.85, 95% confidence interval 1.85-2.88), and functional classes NYHA III-IV (hazard ratio 1.31, 95% confidence interval 1.01-1.70).
  
  
  CONCLUSIONS
  Transcatheter aortic valve implantation constitutes a safe and viable therapeutic option for high operative risk patients with severe aortic stenosis. Long-term prognosis is conditioned by associate comorbidities.
authors.affiliation: Department of Cardiology, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. Electronic address: ajmunozgarcia@secardiologia.es.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Muñoz-García
authors.forename: Raquel
authors.initials: R
authors.lastname: del Valle
authors.forename: Ramiro
authors.initials: R
authors.lastname: Trillo-Nouche
authors.forename: Jaime
authors.initials: J
authors.lastname: Elízaga
authors.forename: Federico
authors.initials: F
authors.lastname: Gimeno
authors.forename: Rosana
authors.initials: R
authors.lastname: Hernández-Antolín
authors.forename: Rui
authors.initials: R
authors.lastname: Teles
authors.forename: Vasco
authors.initials: V
authors.lastname: de Gama Ribeiro
authors.forename: Eduardo
authors.initials: E
authors.lastname: Molina
authors.forename: Angel
authors.initials: A
authors.lastname: Cequier
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Urbano-Carrillo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cruz-González
authors.forename: Miguel
authors.initials: M
authors.lastname: Payaslian
authors.forename: Lino
authors.initials: L
authors.lastname: Patricio
authors.forename: Matías
authors.initials: M
authors.lastname: Sztejfman
authors.forename: Andrés
authors.initials: A
authors.lastname: Iñiguez
authors.forename: Víctor
authors.initials: V
authors.lastname: Rodríguez
authors.forename: Antonio
authors.initials: A
authors.lastname: Scuteri
authors.forename: Carlos
authors.initials: C
authors.lastname: Caorsi
authors.forename: Diego
authors.initials: D
authors.lastname: López-Otero
authors.forename: Pablo
authors.initials: P
authors.lastname: Avanzas
authors.forename: Juan H
authors.initials: JH
authors.lastname: Alonso-Briales
authors.forename: José M
authors.initials: JM
authors.lastname: Hernández-García
authors.forename: César
authors.initials: C
authors.lastname: Morís
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization / Q000401:mortality / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D012042:Registries; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Aortic stenosis; Prosthesis; Transcatheter aortic valve implantation