The Next Frontier - A Novel TAVI Solution RHD

Background: The SHARE-TAVI registry is a prospective multi-centre registry, designed to capture data of all patients undergoing transcatheter aortic valve implantation (TAVI) across South Africa. This registry allows for comparison of local outcomes to international data and to delineate and address the unique challenges faced in a dichotomously funded and resource-constraint healthcare economy.

Methods and Results: 11 Centres perform TAVI across South Africa, but only 3 are state/public sector facilities serving 84% of the national population who do not have medical insurance. All 11 centres actively capture data into a web-based registry. Patients are followed up at 30d and annually for 5 years. Between Sept 2014 to May 2018, 696 patients were assessed as suitable candidates for TAVI, of which only 482 received implants, mostly due to funding being declined or not available. Procedural success (92.5%), 30d mortality (4.8%) and 1-year outcomes (all-cause mortality (11.5%), stroke/TIA (8%), and improvement in NYHA functional class to

Conclusion: In resource-constrained economies, funding remains a major challenge for the appropriate use of TAVI. Local data from independent registries such as SHARE-TAVI may improve access to TAVI in appropriately selected patients.