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Transcatheter aortic valve implantation. Brazilian reality and perspectives!

Transcatheter aortic valve implantation. Brazilian reality and perspectives!. Fábio S. Brito Jr., MD, PhD Hospital Israelita Albert Einstein São Paulo, Brazil fsbrito@einstein.br On behalf of the SBHCI TAVI Registry investigators. Brazil : Population Pyramid by Age and Gender. 1980.

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Transcatheter aortic valve implantation. Brazilian reality and perspectives!

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  1. Transcatheter aortic valve implantation. Brazilian reality and perspectives! Fábio S. Brito Jr., MD, PhD Hospital Israelita Albert Einstein São Paulo, Brazil fsbrito@einstein.br On behalf of the SBHCI TAVI Registry investigators

  2. Brazil: PopulationPyramidby Age andGender 1980 2010 2030 > 75 years: 1,421,000 • 75 years: 5,027,000 • Life Expectancy: 73,5 years • Population: 190,000,000 > 75 years: 11,064,000

  3. CoreValve-Medtronic Sapien-Edwards Inovare-Braile • Approval Jan 2008 • 410 cases: • 395 TF • 10 Subclavian • 05 TransAo • Approval Sept 2011 • 42 cases: • 37 TF • 05 TA • Approval Sept 2011 • 166 cases: • 157 TA • 01 Tao • 08 TF TAVR in Brazil: 618 cases (Jan/2008 - July 2012)

  4. Numbers of TAVR in Brazil(Corevalve + Sapien)

  5. Brazilian TAVI Registry Real World Registry. Electronic Monitoring: 100% Adverse Events Committee: Mortality Endpoints and Complications in acordance with Valve Academic Research Consortium Consensus on Event Definition CoreValve and Sapien cases.

  6. TAVI Registry: Inclusion SBHCI TAVI Registry: 50% of all cases in Brazil and 66% of all CoreValve / Sapien

  7. Inclusion / Center 85% em 5 centros

  8. Brazilian TAVI Registry: Baseline Characteristics * GFR<60ml/min

  9. Brazilian TAVI Registry: Procedure Characteristics

  10. Brazilian TAVI Registry: Echo Results p=ns p<0.001 p<0.001

  11. Brazilian TAVI Registry: 30 Days Results Baseline (277 pts): 30 days (230 pts):

  12. Brazilian TAVI Registry: 30 Days Results

  13. CoreValve Registries:30-Day All-Cause Mortality 25% 20% 15.2% 15.1% 15% 12.4% % 9.7% 9.0% 10% 7.4% 7.2% 5.5% 5.6% 5% 0% Brazilian 18 Fr S&E1 ANZ2 Spain3 French4 Belgian5 German6 UK7 Italian8 1. Medtronic Data on File. COR 2006-02: 18 Fr Safety & Efficacy Study Re-Analysis, August 14, 2009. 2. Meredith. VARC-adjudicated Outcomes in Inoperable and High Risk AS Patients. TCT 2010, Washington, DC. 3. Avanzas P, Munoz-Garcia AJ, Segura J, et al. Percutaneous implantation of the CoreValve® self-expanding aortic valve prosthesis in patientswith severe aortic stenosis: early experience in Spain. Rev Esp Cardiol. 2010;63:141-148. 4. Eltchaninoff. French Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 5. Bosmans. Belgian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 6. Zahn. German Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 7. Ludman. UK Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 8. Petronio. Italian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France.

  14. COREVALVE REGISTRIES:30-Day Stroke Rate 20% 15% 9.6% 10% 4.5% 4.3% 5% 4.0% 4.0% 2.9% 2.6% 1.9% 1.7% 0% ANZ 18 Fr S&E French Belgian German UK Italian ADVANCE Brazilian

  15. COREVALVE REGISTRIES:Pacemaker Implantation Weighted Average 28.5% 60% 50% 42.5% 40.0% 35.2% 40% 31.3% 26.9% 26% 30% 23% 26.3% 18.5% Percent of Patients (%) 24% 20% 10% 0% Belgian2 German2 UK2 ANZ French2 18 Fr S&E Spain1 Italian2 ADVANCE Brazilian

  16. Transcatheter aortic valve implantation. Brazilian reality and perspectives! Thank you!!!!!

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