Transcatheter Aortic Valve Implantation in Brazilian Public Health System: A Single-Center Experience.

BACKGROUND

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

OBJECTIVES

This study aimed to evaluate TAVI exclusively within SUS patients.

METHODS

This was a 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 2 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), and 49.6% were male. The mean aortic valve area was 0.76 cm² and the mean gradient was 45 (±13) mm Hg. 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%). A 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.