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What Have We Learned From The UK TAVI Registry?

What Have We Learned From The UK TAVI Registry?. Simon Ray UHSM Manchester Academic Health Sciences Centre. NO CONFLICT OF INTEREST TO DECLARE. UK TAVI Registry The United Kingdom Transcatheter Aortic Valve Implantation Registry. Development Collaborative program

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What Have We Learned From The UK TAVI Registry?

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  1. What Have We Learned From The UK TAVI Registry? Simon Ray UHSMManchester Academic Health Sciences Centre

  2. NO CONFLICT OF INTEREST TO DECLARE

  3. UK TAVI RegistryThe United Kingdom Transcatheter Aortic Valve Implantation Registry • Development • Collaborative program • Professional Societies (BCIS and SCTS) • Department of Health and Specialist Commissioners • Health Technology Assessment and Regulators (NICE) • High quality data collection and analysis • Dataset developed and distributed in 2008 • Data collection via Central Cardiac Audit Database • encrypted data sent centrally from all units to CCAD servers • Data entered prospectively

  4. UK TAVI Datasetwww.bcis.org.uk

  5. UK TAVI RegistryThe United Kingdom Transcatheter Aortic Valve Implantation Registry Data as 21-5-2010 • 100% of consecutive UK TAVI implants • 1st Jan 2007 to 31st Dec 2009 • Mortality tracking • linkage of central TAVI database with the Office of National Statistics (ONS) • 872 TAVI procedures • 862 successful valve implants, 10 unsuccessful Additional 43 cases from Belfast not included

  6. UK TAVI Registry Demographics Data as 21-5-2010

  7. UK TAVI Registry Casemix Data as 21-5-2010

  8. UK TAVI RegistryThe United Kingdom Transcatheter Aortic Valve Implantation Registry Data as 21-5-2010 *41 subclavian, 2 other undeployed device in 10 cases

  9. UK TAVI Registry Casemix Data as 21-5-2010

  10. UK TAVI Registry In Hospital Outcomes Data as 21-5-2010 Breakdown 54 (6.2%) of patients died 88 (10.1%) died or had MI or CVA 10 died subsequent to CVA or MI 34 had CVA or MI and survived

  11. UK TAVI CentresMortality tracking to Dec 31st 2009 TAVI (intention to Rx) n=872 Mortality tracked n=842 Not tracked:life statusreported at 1 year or discharge n=30 Not tracked Unknown outcome n=0 Tracking 21-5-2010 Survival curves based on n=872

  12. UK TAVI Registry Data as 21-5-2010 Transfemoral Other p=0.017 2 cases route unknown

  13. Unproctored case Subsequent cases Proctored case First 20 cases p=n.s. p=n.s. UK TAVI RegistryMinimising the learning curve? Data as 21-5-2010

  14. UK TAVI RegistryThe United Kingdom Transcatheter Aortic Valve Implantation Registry N=1472 Data as 22/12/10 2007 2008 2009 2010 French Registry N=244, German Registry N=697

  15. Data Submission Timeline

  16. UK TAVI RegistryThe United Kingdom Transcatheter Aortic Valve Implantation Registry

  17. UK TAVI RegistryWhat Have We Learned? Successful implementation of a National dataset UK wide data collection All procedures prospectively captured Incorporates complete experience of all centres including the proctored learning curves Collaboration between all involved Mortality tracking Encouraging early results In hospital mortality: 6.2% 30/7 mortality: 6.9% 1 yr mortality: 19.7%

  18. UK TAVI RegistryWhat Have We Learned? Highlights substantial inequality of commissioned activity Continuing postcode lottery Substantial numbers of patients have no access to a proven treatment

  19. UK TAVI RegistryAcknowledgements – Steering group

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