In-hospital outcome of Transcatheter Aortic Valve Implantation at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Abstract

Background: Transcatheter aortic valve implantation (TAVI) has emerged as a well-established treatment for severe aortic stenosis since its first application in humans in 2002. In Nepal, the inaugural TAVI procedure was performed in February 2022 at the Shahid Gangalal National Heart Centre. This study aims to share our initial experiences and outcomes of TAVI at our center.
Methods: We conducted a retrospective observational study involving all patients who underwent TAVI at our facility between February 2022 and February 2024. This report details patients’ baseline clinical characteristics, procedural data, complications, and in-hospital outcomes.
Results: A total of 19 patients underwent TAVI during the study period. The age of patients ranged from 59 to 90 years, with a mean age of 75.2 ± 7.5 years; 10 patients (52.6%) were female. Four cases (21.1%) involved patients with bicuspid aortic stenosis. Baseline mean aortic valve area measured 0.8 ± 0.1 cm², and the pre-procedural mean pressure gradient was 52.2 ± 10.1 mmHg. Post-procedure, two patients (10.5%) required permanent pacemaker implantation. The balloon-expandable valve was utilized in 12 cases (63.2%), while the self-expandable valve was used in 7 cases (36.8%). The overall procedural success rate was 100%, and all patients were discharged following TAVI, with a mean hospital stay of 4.5 ± 1.8 days. A mild paravalvular leak occurred in one patient (5.3%). Post-TAVI, the mean aortic valve pressure gradient decreased to 8.1 ± 2.6 mmHg.
Conclusions: The outcomes of our initial TAVI procedures are promising, with in-hospital complication and mortality rates comparable to international standards, reinforcing the safety and efficacy of this intervention within our setting.
Keywords: Aortic Stenosis; balloon expandable valve; self-expandable valve; transcatheter aortic valve implantation.