Tavola RotondaTavola Rotonda

Prospettive e sviluppi futuriProspettive e sviluppi futuriProspettive e sviluppi futuriProspettive e sviluppi futuri

Fulvia SeccarecciaFulvia Seccareccia

TAVI versus traditional approaches in treatment of severe and symptomatic TAVI versus traditional approaches in treatment of severe and symptomatic

aortic aortic stenosisstenosis patientspatients

�� To find out the actual gain in the short, medium and longTo find out the actual gain in the short, medium and long--term prognosis (survival, term prognosis (survival,

occurrence of reoccurrence of re--interventions and major adverse cardiac and interventions and major adverse cardiac and cerebrovascularcerebrovascular events events --

MACCE) of the TAVI procedure in comparison with AVR, VP and MT, in a high preMACCE) of the TAVI procedure in comparison with AVR, VP and MT, in a high pre--

operative risk subgroup of the Italian SSAS population.operative risk subgroup of the Italian SSAS population.

Costs, Cognitive abilities and Quality of life of Costs, Cognitive abilities and Quality of life of transcathetertranscatheter aortic valve aortic valve

implantation and surgical aortic valve replacement (CCQ)implantation and surgical aortic valve replacement (CCQ)

�� Description of Description of neurocognitiveneurocognitive status before and after TAVI and AVR proceduresstatus before and after TAVI and AVR procedures

�� Description of Quality of Life (Description of Quality of Life (QoLQoL) after these procedures) after these procedures

�� Defining the relevance of baseline psychological, emotional and cognitive factors on the Defining the relevance of baseline psychological, emotional and cognitive factors on the

outcomes associated to the different treatment modalitiesoutcomes associated to the different treatment modalities

�� Assessment of costs associated to each of the above mentioned strategies of Assessment of costs associated to each of the above mentioned strategies of

treatment, including costs of the index hospitalization and costs of followtreatment, including costs of the index hospitalization and costs of follow--upup

Comparative effectiveness of AVR and TAVI procedures for severe Comparative effectiveness of AVR and TAVI procedures for severe

symptomatic aortic symptomatic aortic stenosisstenosis treatment: results from the realtreatment: results from the real--world world

�� New data collection on short and long term prosthetic valve performance (gradient, New data collection on short and long term prosthetic valve performance (gradient, paravalvularparavalvular

leak and prosthetic insufficiency) leak and prosthetic insufficiency)

�� Incidence of inIncidence of in--hospital major adverse cardiac and hospital major adverse cardiac and cerebrovascularcerebrovascular events (MACCE) at 12, 24 and events (MACCE) at 12, 24 and

36 months from interventions; intra36 months from interventions; intra--procedural and 24procedural and 24--month prosthetic valve performance. month prosthetic valve performance.

�� PrePre--procedure risk score for short term outcomes, specific for the SSAS Italian population, using procedure risk score for short term outcomes, specific for the SSAS Italian population, using

the propensity adjustment approachthe propensity adjustment approach

The PRIORITY Study The PRIORITY Study -- PRedictIngPRedictIng longlong--term Outcomes term Outcomes afteRafteR Isolated Isolated

coronary coronary arTeryarTery bypass bypass surgerYsurgerY

�� To create a risk score predicting mid and long term mortality and major adverse To create a risk score predicting mid and long term mortality and major adverse

cardiac and cardiac and cerebrovascularcerebrovascular events (MACCE) after isolated CABG surgery using events (MACCE) after isolated CABG surgery using

patients prepatients pre--operative clinical characteristicsoperative clinical characteristics

�� To build a risk function predicting mid term reTo build a risk function predicting mid term re--hospitalizations for patients hospitalizations for patients

undergoing isolated CABG surgery using administrative data properly supplemented undergoing isolated CABG surgery using administrative data properly supplemented

by few selected patients preby few selected patients pre--operative clinical characteristics operative clinical characteristics

�� studio studio osservazionaleosservazionale su pazienti con su pazienti con strokestroke criptogenicocriptogenico e PFO, per e PFO, per

la valutazione comparativa di efficacia della chiusura la valutazione comparativa di efficacia della chiusura endovascolareendovascolare

del PFO vs il trattamento medico, in termini di recidive neurologiche del PFO vs il trattamento medico, in termini di recidive neurologiche

a 36 mesi dal trattamento. a 36 mesi dal trattamento.