Objective
TAVI is a quite new methodology and following the international guidelines it should be only for selected type of patients. The long term safety of this valves is not yet comparable with the standard biological ones. The eligible patients should be those that are not operable with the gold standard technique or very high risk patients. The aim of this study is to evaluate the appropriate use of the TAVI procedure within our hospital setting.
Methods
We first defined the trend of total stenotic AVR (ICD 9 code 35.21) in our hospital before and after the TAVI introduction. We used a monthly time series analysis (Joinpoint regression analysis) to see how was this trend in time from January 2000 to 2012 and then we extend the monitoring to 2014. Then we use the same analysis to evaluate the trend of only standard biological valve implants.
Results
We statistically demonstrate that the trend of total AVR is increasing steadily in time (monthly percentage change of +0,81) but there are no significant angulations (Joinpoints) in the trend. The time series analysis of the trend of only standard biological valve implants showed that in the begging when only the interventional cardiology department started to use them there was no statistical modification of the trend. Surprisingly we discover that when the cardiac surgery department started to use the TAVI as well, a significant trend modification was in place. The standard biological valve implants decreased significantly with a trend of -1.05 monthly percentage change.
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