| Abstract | Cilj istraživanja: Cilj istraživanja je utvrditi postoje li razlike u kliničkim, anamnestičkim, laboratorijskim i proceduralnim obilježjima bolesnika liječenih transkateterskom implantacijom aortnog zaliska u KBC-u Split u 2019./2020. i 2023. godini. Ispitanici i postupci: Istraživanje je obuhvatilo ukupno 187 bolesnika s dijagnozom teške aortne stenoze koji su podvrgnuti transkateterskoj implantaciji aortnog zaliska (engl. transcatheter aortic valve replacement, TAVI) tijekom 2019., 2020. i 2023. godine. Prikupljeni su osnovni klinički i proceduralni podaci iz BIS-a i bolničke arhive. Kako bi usporedili rezultate, bolesnici su podijeljeni u dvije skupine: skupina 2019./2020. i skupina 2023. Rezultati: U skupini 2019./2020. bilo je 39 bolesnika, dok je u skupini 2023. bilo 148 bolesnika. Medijan životne dobi ukupne kohorte bio je 82 godine (IQR=6,5) i nije se značajno promijenio s vremenom (P=0,366). Udio bolesnika starosti ≤75 godina je ostao isti (15,38% u 2019./2020. i 16,22% u 2023.). Skupina iz 2023. godine imala je značajno kraći medijan boravka u bolnici, 3 dana u usporedbi sa 6 dana u 2019./2020. skupini (P<0,001). Procijenjeni EuroSCORE II smanjio se s 4,4% u 2019./2020. na 3,71% u 2023. (P=0,649). U skupini iz 2023. bilo je više bolesnika u NYHA 4 stupnju zatajivanja srca (12,84% vs. 0%, P=0.054). U cijeloj kohorti 81,82% bolesnika imalo je arterijsku hipertenziju, 39,57% fibrilaciju atrija, a 33,16% šećernu bolest. Nije bilo značajnih razlika u većini komorbiditeta između dviju skupina. U skupini 2019./2020. bilo je značajno više bolesnika koji su ranije podvrgnuti perkutanoj koronarnoj intervenciji (33,33% vs. 14,19%, P=0,012). Primjena balonske predilatacije i postdilatacije nije se značajno promijenila tijekom vremena. Najčešće se koristio transfemoralni pristup, iako je mali broj procedura u 2023. godini napravljeno preko transaksilarnog pristupa. U cijeloj kohorti, najčešće implantirani zalisci bili su Medtronic Evolut PRO + (31,5%, N=57) i Edwards Sapien 3 (25,4%, N=46) Zaključak: U periodu od četiri godine prati se višestruki porast TAVI procedura, korišteno je više vrsta zalistaka i vaskularnih pristupa te složenijih postupaka. Značajno je smanjen broj dana hospitalizacije. Opterećenje komorbiditetima i dob nisu se značajno promijenili. |
| Abstract (english) | Objectives: The aim of this study is to determine whether there are differences in the clinical, laboratory and procedural characteristics of patients treated with transcatheter aortic valve implantation (TAVI) at University Hospital of Split in 2019-2020 and 2023. Subjects and methods: The study included 187 patients diagnosed with severe aortic stenosis who underwent TAVI during 2019, 2020 and 2023. Basic clinical and procedural data were collected from the hospital's BIS system and archives. To compare the outcomes, patients were divided into two groups: the 2019-2020 group and the 2023 group. Results: The 2019-2020 group had 39 patients, while the 2023 group had 148 patients. The median age for the entire cohort was 82 years (IQR=6.5), with no significant change over time (P=0.366). The proportion of patients aged ≤75 years remained the same (15.38% in 2019-2020 and 16.22% in 2023). The 2023 group had a significantly shorter median hospital stay, 3 days compared to 6 days in the 2019-2020 group (P<0.001). The estimated EuroSCORE II decreased from 4.4% to 3.71% in 2023 (P=0.649). In the 2023 group there were more patients classified as NYHA class 4 for heart failure (12.84% compared to 0% in 2019-2020; P=0.054). In the entire cohort, 81.82% of patients had arterial hypertension, 39.57% had atrial fibrillation, and 33.16% had diabetes. No significant differences were found in most comorbidities between the two groups. The 2019-2020 group had significantly more patients who had previously undergone percutaneous coronary intervention (33.33% vs. 14.19%, P=0.012). The use of balloon pre-dilation and post-dilation did not change significantly over time. The transfemoral access was most commonly used, although a small number of procedures in 2023 were performed using the transaxillary access. In the entire cohort, the most commonly implanted valve was the Medtronic Evolut PRO + (31.5%, N=57) and Edwards Sapien 3 (25.4%, N=46). Conclusion: Over the four-year period, there has been a significant increase in TAVI procedures, with the use of various types of valves and vascular access routes, and more complex procedures. The length of hospital stay has been significantly reduced. The comorbidities burden and patient age did not change significantly during the observed period. |
