What does this research mean for the field?

TAVI yields long-term outcomes in patients aged ≥85 years that are comparable to those under 85 years, with all-cause mortality rates of 37.5% vs. 30.7%. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

February 6, 2026

TAVI in very elderly patients: long-term outcomes in a real-world cohort

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Severe symptomatic aortic stenosis (n=210). Intervention: Transcatheter aortic valve implantation (TAVI) in patients aged ≥85 years vs. TAVI in patients aged <85 years. Primary outcome: Major adverse cardiovascular events (MACE) (p=0.244).

Q: What question did this study set out to answer?

This research examines the long-term outcomes of transcatheter aortic valve implantation (TAVI) in patients aged 85 years and older compared to younger individuals.

Key Result

TAVI in patients aged ≥85 years yielded long-term major adverse cardiovascular event rates comparable to those in patients <85 years (46.8% vs. 41.2%, p=0.244).

Key Points

This research examines the long-term outcomes of transcatheter aortic valve implantation (TAVI) in patients aged 85 years and older compared to younger individuals.
Conducted a retrospective study at a single center in 2019.
Included patients with severe symptomatic aortic stenosis undergoing TAVI.
Stratified patients into two age groups: under 85 years and 85 years or older.
Collected long-term follow-up data on major adverse cardiovascular events and all-cause mortality.
210 patients enrolled, with 96 aged 85 and older.
No significant differences in procedural success rates or pre-procedural echocardiographic parameters.
Major adverse cardiovascular events occurred more frequently in the older group, but not significantly (46.8% vs. 41.2%).
All-cause mortality rates were comparable between age groups (30.7% in U85 vs. 37.5% in O85).

Study Design

Type

Cohort (n=210)

Multicenter

Structured PICO

Does TAVI in patients aged ≥85 years yield comparable long-term outcomes to patients <85 years with severe symptomatic AS?

Population

210 patients with severe symptomatic aortic stenosis (AS) who underwent TAVI, including 96 individuals aged ≥85 years. 61% female.

Intervention

Transcatheter aortic valve implantation (TAVI) in patients aged ≥85 years (O85)

Comparator

Transcatheter aortic valve implantation (TAVI) in patients younger than 85 years (U85)

Outcome

Major adverse cardiovascular events (MACE), all-cause mortality and heart failure-related hospitalizations at mean 4.2 years follow-upcomposite

TAVI in carefully selected patients aged ≥85 years yields long-term outcomes comparable to younger patients, suggesting advanced age alone should not preclude the procedure.

Main Result

Absolute Event Rate: 46.8% vs 41.2%

p-value: p=0.244

Abstract

Abstract Introduction Over the past two decades, transcatheter aortic valve implantation (TAVI) has emerged as a key therapeutic option for severe symptomatic aortic stenosis (AS) in high-surgical-risk patients, progressively expanded to include all surgical risk categories. While its use is increasing among older populations, evidence on outcomes in the very elderly remains controversial. Material and Methods We conducted a single-center, high-volume, retrospective study including all patients with severe symptomatic AS who underwent TAVI in 2019, following thorough strict evaluation and approval by the local Heart Team. Patients were stratified into two groups according to age: those younger than 85 years (Under 85 U85) and those aged 85 or older (Over 85 O85). Long-term follow-up data were collected on major adverse cardiovascular events (MACE), all-cause mortality and heart failure-related hospitalizations, defined as the first event occurring after the procedure. Results A total of 210 patients were enrolled, including 96 individuals aged ≥85 years (O85). The mean age was 80.2±3.6 in U85 and 87.9±2.4 in O85 (p0.001). The cohort comprised 128 females (61% of the total; U85: 67 vs. O85: 61; p = 0.480). Both groups exhibited a high burden of comorbidities, with no statistically significant differences. Procedural success was achieved in all patients. Pre-procedural echocardiographic parameters were comparable, and post-TAVI hemodynamic outcomes showed no significant differences between groups. At a mean follow-up of 4.2 ± 1.4 years, MACE occurred more frequently in O85 than in U85 (46.8% vs. 41.2%), but the difference was not statistically significant (p = 0.244). All-cause mortality rates were also comparable (U85: 35 30.7% vs. O85: 36 37.5%, p = 0.300). Heart failure hospitalization rates were numerically higher in U85 (U85: 12 10.5% vs. O85: 9 9.4%), though without statistical significance (p = 0.979). Kaplan-Meier analysis demonstrated no significant differences in survival between the two groups (log-rank p = 0.345). Conclusion TAVI in patients aged ≥85 years yields long-term outcomes comparable to those in their relatively younger counterparts. Patients in this age group appear to have effectively overcome competing risks and may demonstrate greater resilience to life stressors. Moreover, the rigorous selection process by the Heart Team likely minimizes futile cases, ensuring appropriate patient selection.

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