INTRODUCTION The management of patients with severe aortic stenosis (AS) may differ according to patient age. The aim of this analysis was to describe patterns of aortic valve replacement (AVR) use in European countries stratified by age. METHODS Procedure volume data for AVR, including surgical aortic valve replacement (sAVR) and transcatheter aortic valve implantation (TAVI), for the years 2015-2020 were obtained from national databases for twelve European countries (Austria, Czech Republic, Denmark, England, Finland, France, Germany, Norway, Poland, Spain, Sweden, and Switzerland). Procedure volumes were reported by patient age (<50 years, by five-year age groups between 50 and 85 years, and ≥85 years). Patients per million population (PPM) undergoing AVR each year were calculated using population estimates from Eurostat. RESULTS AVR PPM varied widely between countries, from 508 PPM in Germany to 174 PPM in Poland in 2020. TAVI rates ranged from 61% in Switzerland and Finland to 25% in Poland. AVR PPM increased with age to a peak at 80-84 years, after which it decreased again. AVR procedures increased from 2015 to 2019 at an average annual rate of 3.9%. AVR increased more substantially in people aged ≥80 years than in younger age groups; these older age groups accounted for 30% of all AVR procedures in 2015 and 35% in 2019. TAVI accounted for an increasing proportion of all AVR procedures as patient age increased; an overall average of 96% of males and 98% of females aged ≥85 years received TAVI as the treatment modality, although adoption of TAVI differed between countries. CONCLUSIONS There is considerable variation in the rates of AVR use and the adoption of TAVI versus sAVR between European countries. The use of TAVI has increased in recent years, particularly for older patients.  .

中文翻译：

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欧洲主动脉瓣置换的模式：按年龄划分的采用情况。

简介 严重主动脉瓣狭窄 (AS) 患者的治疗可能会根据患者年龄的不同而有所不同。本分析的目的是描述欧洲国家按年龄分层的主动脉瓣置换术 (AVR) 使用模式。方法 2015-2020 年 AVR 手术量数据，包括外科主动脉瓣置换术 (sAVR) 和经导管主动脉瓣植入术 (TAVI)，从 12 个欧洲国家（奥地利、捷克共和国、丹麦、英国、芬兰）的国家数据库中获取、法国、德国、挪威、波兰、西班牙、瑞典和瑞士）。手术量按患者年龄（<50 岁、50 至 85 岁之间的五年年龄组、≥85 岁）报告。每年接受 AVR 的每百万人口 (PPM) 患者是根据欧盟统计局的人口估计值计算的。结果 各国之间的 AVR PPM 差异很大，从德国的 508 PPM 到 2020 年波兰的 174 PPM。TAVI 比率从瑞士和芬兰的 61% 到波兰的 25%。AVR PPM 随着年龄的增长而增加，在 80-84 岁达到峰值，之后再次下降。2015年至2019年AVR手术年均增长率为3.9%。年龄≥80 岁的人群的 AVR 比年轻年龄组的增加幅度更大；这些年龄较大的人群在 2015 年占所有 AVR 手术的 30%，在 2019 年占 35%。随着患者年龄的增加，TAVI 在所有 AVR 手术中所占的比例越来越大；尽管各国采用 TAVI 的情况不同，但年龄 ≥ 85 岁的男性和女性总体平均有 96% 和 98% 接受 TAVI 作为治疗方式。结论 欧洲国家之间 AVR 的使用率以及 TAVI 与 sAVR 的采用率存在很大差异。近年来，TAVI 的使用有所增加，特别是对于老年患者。。