Background: Since its commercialization in 2007, the number of transcatheter aortic valve replacement (TAVR) procedures has grown exponentially worldwide. The penetrance of TAVR in Latin America as compared with North America and Europe is unknown. 

Objective: We sought to examine the penetrance of TAVR in Latin America compared to Europe and North America. 

Methods: Data were collected from the BIBA MedTech registry obtained by continuous surveillance from lead physicians performing TAVR procedures in North America, Europe, and Latin America. An online form describing the number of TAVR procedures and access routes was used. Furthermore, an index of TAVR per 100,000 individuals within each population in 2023 was calculated. Variation between regions was assessed by incidence rate ratio with Poisson analysis. Significance was assumed at p<0.05.

Results: Between 2014 and 2023, the number of TAVR was higher in North America (61,3790 procedures) and Europe (61,8161 procedures) as compared with Latin America   (30,874 procedures). Over the 9-year study period, North America experienced a substantial absolute increment in TAVR procedures (15,190 vs. 98,285), as did Europe (26,743 vs. 98,647), while Latin America showed a modest absolute increment (1,088 vs. 6,566). Considerable variation in TAVR use existed across nations in Latin America led by Brazil with 11,178 procedures followed by Argentina with 7,571 procedures. Overall, the transfemoral approach was the most commonly utilized (92%), followed by the subclavian route (2.2%). The rate of TAVR per 100,000 population in 2023, was significantly lower in Latin America compared to the USA (1.51 vs 17.57, IRR 0.08 CI95 [0.009 - 0.35], p < 0.001) and Europe (1.51 vs 21.39, IRR 0.09 CI95% [0.01 - 0.38], p<0.001)(Figure 1).  

Conclusion: TAVR adoption in Latin America has been slow, significantly trailing behind the average TAVR utilization rates observed in North America and Europe. These findings underscore the importance of raising awareness among healthcare providers, particularly as TAVR continues to emerge as the standard of care for severe aortic stenosis.