Australian Cardiac Outcomes Registry of Transcatheter Aortic Valve Implantation: Report and Update of Transcatheter Aortic Valve Implantation in Australia

Background: Transcatheter aortic valve implantation (TAVI) procedures performed in Australia are recorded in the national Australian Cardiac Outcomes Registry (ACOR) TAVI Registry. Characteristics of patients and operators are prospectively collected with reference to patient demographics, procedural factors as well as outcomes related to both efficacy and safety metrics. Methods: Patient level data reported to the ACOR TAVI Registry from enrolled sites from registry inception up until 31 December 2021 were analysed. Key safety and efficacy metrics were identified and used to assess TAVI performance and outcomes in the Australian setting. Results: From 10 April 2018 to 31 December 2021, 9,881 consecutive patients underwent a TAVI procedure in Australia across 42 TAVI hospitals. The mean age of patients treated was 81.8 years (± standard deviation [SD] 7.1 years), 40.6% were female and the mean STS (Society for Thoracic Surgeons) score was 5.3% (±SD 4.4%). Overall, 0.3% of the cohort identified as Australian Aboriginal or Torres Strait Islander peoples. All-cause mortality at 30 days and 12 months was 1.37% and 5.57% respectively. The 30-day rates of stroke, major vascular complications and newly implanted permanent pacemaker were 2.19%, 1.23% and 10.68% respectively. There were 181 unique primary operators who performed TAVI during this time with an annualised median number of 19 procedures per operator per year (interquartile range [IQR] 42.5) and 63% of operators performed <30 cases per year. Conclusions: TAVI is being performed in Australia with the encouraging outcomes described. These would appear to compare favourably with other international datasets.