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Peer-reviewedCC BY 4.0Cardiovascular Intervention and Therapeutics

Longitudinal Trends and Outcomes in Transcatheter Aortic Valve Implantation: a report from the SwissTAVI Registry

  • Thorald Stolte1
  • Jakob Johannes Reichl1
  • David Tueller2
  • Felix Goetzinger1
  • Max Wagener1
  • Stefan Stortecky3,4
  • Raban Jeger1,2
  • Oliver Reuthebuch5
  • Stefan Toggweiler6
  • Enrico Ferrari7
  • Peter Wenaweser8
  • Fabian Nietlispach9
8 more authors
  • Christoph Huber10
  • Marco Roffi10
  • Dik Heg11
  • David Meier12
  • Stephan Windecker3
  • Felix Mahfoud1
  • Stephane Noble10
  • Thomas Nestelberger1
12 affiliations
  1. 1Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, 4, CH-4031, Basel, Switzerland
  2. 2Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland
  3. 3Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
  4. 4Department of Cardiology, Lausanne University Hospital – CHUV, Lausanne, Switzerland
  5. 5Department of Cardiac Surgery, University Hospital Basel, University of Basel, Basel, Switzerland
  6. 6Department of Cardiology, Heart Center, Cantonal Hospital Lucerne, Lucerne, Switzerland
  7. 7Department of Cardiovascular Surgery, Cardiocentro Ticino Institute, Lugano, Switzerland
  8. 8Heart Clinic Hirslanden, Hirslanden Clinic Zurich, Zurich, Switzerland
  9. 9Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
  10. 10Division of Cardiology and Cardiovascular Surgery, University Hospital, Geneva, Switzerland
  11. 11Department of Clinical Research, University of Bern, Bern, Switzerland
  12. 12Division of Cardiology, University Hospital, Lausanne, Switzerland
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Abstract

The progressive expansion of indications for Transcatheter Aortic Valve Implantation (TAVI) towards lower-risk and younger populations has raised concerns about potential outcome attenuation with increasing procedural volumes. Real-world evidence addressing this concern is limited. To assess temporal trends in patient characteristics and procedural outcomes of TAVI in a large nationwide cohort. The Swiss TAVI Registry prospectively enrolled consecutive patients undergoing TAVI in Switzerland. Baseline characteristics, procedural complications and outcomes were compared across three periods: 2011-2015, 2016-2020 and 2021-2024. The primary endpoint was major adverse cardiovascular events (MACE: all-cause mortality, non-fatal myocardial infarction, and non-fatal stroke) at one year. The secondary endpoint was 30-day MACE. Among 19’452 patients, TAVI volume increased 27% annually. Patient age (82 years) and comorbidity burden remained stable, while the proportion of women increased (51% to 58%) and the median STS score decreased (4.5% to 3.3%). Considering the expansion to lower-risk patients, 1-year MACE declined significantly from 16% to 14% to 9.1% across periods (adjusted HR 0.69, 95% CI 0.62-0.78, p<0.001). Similarly, 30-day MACE decreased from 6.9% to 5.2% to 4.0% (adjusted HR 0.66, 95%CI 0.55-0.78, p<0.001). Procedural mortality declined from 2.9% to 1.2%, periprocedural myocardial infarction from 0.4% to 0.2% and stroke from 3.2% to 2.0% (all p<0.001).Risk-adjusted TAVI outcomes improved continuously despite a significant volume increase, with improvements exceeding those expected from lower-risk patients risk profiles alone.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s12928-026-01310-1.

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Cite

BibTeXRIS
BibTeX
@article{stolte2026longitudinal,
  title = {{Longitudinal Trends and Outcomes in Transcatheter Aortic Valve Implantation: a report from the SwissTAVI Registry}},
  author = {Thorald Stolte and Jakob Johannes Reichl and David Tueller and Felix Goetzinger and Max Wagener and Stefan Stortecky and Raban Jeger and Oliver Reuthebuch and Stefan Toggweiler and Enrico Ferrari and Peter Wenaweser and Fabian Nietlispach and Christoph Huber and Marco Roffi and Dik Heg and David Meier and Stephan Windecker and Felix Mahfoud and Stephane Noble and Thomas Nestelberger},
  journal = {Cardiovascular Intervention and Therapeutics},
  year = {2026},
  month = jun,
  doi = {10.1007/s12928-026-01310-1},
  url = {https://doi.org/10.1007/s12928-026-01310-1},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Longitudinal Trends and Outcomes in Transcatheter Aortic Valve Implantation: a report from the SwissTAVI Registry
AU  - Thorald Stolte
AU  - Jakob Johannes Reichl
AU  - David Tueller
AU  - Felix Goetzinger
AU  - Max Wagener
AU  - Stefan Stortecky
AU  - Raban Jeger
AU  - Oliver Reuthebuch
AU  - Stefan Toggweiler
AU  - Enrico Ferrari
AU  - Peter Wenaweser
AU  - Fabian Nietlispach
AU  - Christoph Huber
AU  - Marco Roffi
AU  - Dik Heg
AU  - David Meier
AU  - Stephan Windecker
AU  - Felix Mahfoud
AU  - Stephane Noble
AU  - Thomas Nestelberger
PY  - 2026
DA  - 2026/06/15
JO  - Cardiovascular Intervention and Therapeutics
DO  - 10.1007/s12928-026-01310-1
UR  - https://doi.org/10.1007/s12928-026-01310-1
AB  - The progressive expansion of indications for Transcatheter Aortic Valve Implantation (TAVI) towards lower-risk and younger populations has raised concerns about potential outcome attenuation with increasing procedural volumes. Real-world evidence addressing this concern is limited. To assess temporal trends in patient characteristics and procedural outcomes of TAVI in a large nationwide cohort. The Swiss TAVI Registry prospectively enrolled consecutive patients undergoing TAVI in Switzerland. Baseline characteristics, procedural complications and outcomes were compared across three periods: 2011-2015, 2016-2020 and 2021-2024. The primary endpoint was major adverse cardiovascular events (MACE: all-cause mortality, non-fatal myocardial infarction, and non-fatal stroke) at one year. The secondary endpoint was 30-day MACE. Among 19’452 patients, TAVI volume increased 27% annually. Patient age (82 years) and comorbidity burden remained stable, while the proportion of women increased (51% to 58%) and the median STS score decreased (4.5% to 3.3%). Considering the expansion to lower-risk patients, 1-year MACE declined significantly from 16% to 14% to 9.1% across periods (adjusted HR 0.69, 95% CI 0.62-0.78, p<0.001). Similarly, 30-day MACE decreased from 6.9% to 5.2% to 4.0% (adjusted HR 0.66, 95%CI 0.55-0.78, p<0.001). Procedural mortality declined from 2.9% to 1.2%, periprocedural myocardial infarction from 0.4% to 0.2% and stroke from 3.2% to 2.0% (all p<0.001).Risk-adjusted TAVI outcomes improved continuously despite a significant volume increase, with improvements exceeding those expected from lower-risk patients risk profiles alone.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s12928-026-01310-1.
SN  - 1868-4300
SN  - 1868-4297
ER  -