Regional differences in aortic valve replacements: Atlantic Canadian experience

Connor McGuire, Alexandra M. Yip, Jeffrey B. MacLeod, Vernon Paddock, Sohrab Lutchmedial, Najef Nadeem, Greg Hirsch, Corey Adams, Kevin Melvin, Sean Connors, Ansar Hassan, Jean François Légaré

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Transcatheter aortic valve implantation (TAVI) is evolving rapidly and is increasingly being adopted in the treatment of aortic valve disease. The goal of this study was to examine regional differences in surgical aortic valve replacement (SAVR) and TAVI across Atlantic Canada. Methods: We identified all patients who underwent SAVR or TAVI between Jan. 1, 2010, and Dec. 31, 2014, in New Brunswick, Nova Scotia and Newfoundland and Labrador. Data obtained included patient demographic characteristics and surgical procedure details. We performed univariate descriptive analyses and calculated crude and age- and sex-adjusted incidence rates. Results: A total of 3042 patients underwent SAVR or TAVI during the study period, 1491 in Nova Scotia, 1042 in New Brunswick and 509 in Newfoundland and Labrador. Patient demographic characteristics were similar across regions. A much higher proportion of patients in Newfoundland and Labrador (43.6%) than in Nova Scotia (4.2%) or New Brunswick (13.6%) received a mechanical versus a bioprosthetic valve. Rates of TAVI increased over the study period, with New Brunswick adopting their program before Nova Scotia (144 v. 74 procedures). Adjusted rates of all AVR procedures remained stable in Nova Scotia (40–50 per 100 000 people). Adjusted rates were lower in New Brunswick and Newfoundland and Labrador than in Nova Scotia; they increased slowly in New Brunswick over the study period. Conclusion: Despite geographical proximity and similar patient demographic characteristics, there existed regional differences in the management of aortic valve disease within Atlantic Canada. Further study is required to determine whether the observed differences in age- and sex-adjusted rates of AVR may be explained by geographical disease-related differences, varying practice patterns or barriers in access to care.

Original languageEnglish
Pages (from-to)99-104
Number of pages6
JournalCanadian Journal of Surgery
Volume61
Issue number2
DOIs
Publication statusPublished - Apr 2018

Bibliographical note

Publisher Copyright:
© 2018 Joule Inc.

ASJC Scopus Subject Areas

  • Surgery

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