Transcatheter Aortic Valve Implantation in Brazilian Public Health System: A single center experience.

Abstract

Background: Transcatheter aortic valve implantation (TAVI) has been established as the treatment of choice for severe aortic stenosis in high risk as well as patients above 75 years-old in all risk spectrums. Despite its worldwide adoption, implementation in lower-middle-income countries such as Brazilian public health system (SUS, acronym in Portuguese) is incipient.

Objectives: This study aimed to evaluate TAVI exclusively within SUS patients.

Methods: This was prospective cohort study in a public tertiary hospital in southern Brazil. All patients who underwent TAVI between 2018 and 2024 were included. The cohort was divided into two temporal periods: from July 2018 to December 2022 (n=60) and January 2023 to October 2024 (n=65). The clinical and procedural characteristics and in-hospital as well as 1 year of outcomes were evaluated according to Valve Academic Research Consortium-2 (VARC-2) criteria.

Results: During the study period, 125 patients underwent TAVI. The average age was 80 years (± 10), 49.6% were male. The mean aortic valve area was 0.76 cm2 and the mean gradient was 45 (±13) mmHg. The mean STS predicted risk of mortality (STS-PROM) score was 4.6% (±3.6). Device success was achieved in 119 patients (95.2%). In-hospital mortality was 2 (1.6%). New permanent pacemaker was required in 16 (12.8%). Demographic and clinical characteristics between the first and the second periods were similar.

Conclusions: The mortality and complications rate of TAVI performed within the scope of the Brazilian public health system were consistent with the clinical experience of other international registries.