Display options
Share it on

Postepy Kardiol Interwencyjnej. 2017;13(1):10-17. doi: 10.5114/aic.2017.66181. Epub 2017 Mar 10.

The Polish Interventional Cardiology TAVI Survey (PICTS): adoption and practice of transcatheter aortic valve implantation in Poland.

Postepy w kardiologii interwencyjnej = Advances in interventional cardiology

Radosław Parma, Maciej Dąbrowski, Andrzej Ochała, Adam Witkowski, Dariusz Dudek, Zbigniew Siudak, Jacek Legutko

Affiliations

  1. 3 Department of Cardiology, Medical University of Silesia, Katowice, Poland.
  2. Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
  3. Department of Interventional Cardiology, Jagiellonian University Medical College, Kraków, Poland.
  4. 2 Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland.

PMID: 28344612 PMCID: PMC5364277 DOI: 10.5114/aic.2017.66181

Abstract

INTRODUCTION: Few studies have assessed the development of transcatheter aortic valve implantation (TAVI) in Poland since its introduction in 2008, and data on current TAVI activity or practice are missing.

AIM: To assess the dynamics of TAVI adoption in Poland and to detect differences among Polish centres in TAVI practice and decision-making.

MATERIAL AND METHODS: The Polish Interventional Cardiology TAVI Survey (PICTS) was approved by the Polish Association of Cardiovascular Interventions and presented to all 21 national TAVI centres. Between 2008 and 2015 the cumulative number of TAVI performed in Poland was 2189. The annual number of TAVI rose from 8 in 2008 to 670 in 2015 (0.21 to 17.4 implants per million inhabitants, respectively).

RESULTS: The median TAVI experience per centre was 80 procedures (95% CI: 38.1-154.6). In 2015 the TAVI penetration rate reached 5.12% of the estimated eligible Polish population. Inoperable and high-risk patients are treated with TAVI in all centres, with 52% of Heart Teams also qualifying medium-risk patients. The rate of transfemoral implantations increased to 83.2% of all procedures in 2015, while transapical implantations decreased to 12%. The frequency of subclavian, direct aortic or transcarotid routes in 2015 was below 3% each.

CONCLUSIONS: The PICTS survey observed a positive but slow rate of adoption of TAVI in Poland. When compared to Western European countries, our findings highlight a significant treatment gap in high or prohibitive surgical risk patients with severe aortic stenosis. Remarkable variations in TAVI practices among Polish TAVI centres warrant publication of joint national guidelines and recommendations.

Keywords: Heart Team; aortic valve regurgitation; aortic valve stenosis; heart failure; transcatheter aortic valve implantation; transcatheter aortic valve replacement

Conflict of interest statement

The authors declare no conflict of interest.

References

  1. JACC Cardiovasc Interv. 2015 Oct;8(12):1608-13 - PubMed
  2. J Am Coll Cardiol. 2013 Jul 16;62(3):210-9 - PubMed
  3. N Engl J Med. 2016 Apr 28;374(17 ):1609-20 - PubMed
  4. Eur Heart J. 2016 Dec 14;37(47):3503-3512 - PubMed
  5. EuroIntervention. 2016 Jan 22;11(9):968-70 - PubMed
  6. Catheter Cardiovasc Interv. 2014 Mar 1;83(4):649-54 - PubMed
  7. Circulation. 2002 Dec 10;106(24):3006-8 - PubMed
  8. J Am Coll Radiol. 2013 Dec;10 (12 ):957-65 - PubMed
  9. Eur Heart J. 2015 Dec 14;36(47):3370-9 - PubMed
  10. Catheter Cardiovasc Interv. 2013 Feb;81(2):376-83 - PubMed
  11. EuroIntervention. 2015 Oct;11(6):690-7 - PubMed
  12. EuroIntervention. 2016 Jan 22;11(9):977-9 - PubMed
  13. EuroIntervention. 2016 Jan 22;11(9):1029-33 - PubMed
  14. EuroIntervention. 2013 Apr 22;8(12):1362-71 - PubMed
  15. Eur Heart J. 2008 Jun;29(11):1463-70 - PubMed
  16. EuroIntervention. 2013 Sep 10;9 Suppl:S48-54 - PubMed
  17. EuroIntervention. 2015 Sep;11 Suppl W:W92-5 - PubMed
  18. J Cardiovasc Comput Tomogr. 2012 Nov-Dec;6(6):366-80 - PubMed
  19. J Am Coll Cardiol. 2013 Sep 10;62(11):1002-12 - PubMed
  20. J Am Coll Cardiol. 2012 May 29;59(22):2028-42 - PubMed
  21. EuroIntervention. 2016 Sep 18;12 (7):890-5 - PubMed

Publication Types