In patients ≤65 years undergoing TAVI, 5-year survival was 88% in low/intermediate risk and 78% in high-risk groups, with 0.7% 30-day mortality.
What are the predicted risks, procedural outcomes, and longitudinal survival of patients ≤65 years undergoing TAVI?
Most patients ≤65 years receiving TAVI are of low surgical risk and achieve 88% 5-year survival, highlighting the need for careful heart team evaluation given the cumulative longitudinal risks of TAVI in young patients.
Tasa de eventos absoluta: 0% vs 0%
Abstract Objectives Recent data suggest that 50% of patients ≤65 years of age undergo Transcatheter Aortic Valve Implantation (TAVI). It has also been suggested that these patients are typically high risk with poor life expectancy. We sought to evaluate predicted risk, procedural and longitudinal outcomes and cost in patients ≤65 years who received TAVI in the Premier Healthcare Database. Methods All patients aged 65 and younger receiving TAVI (2017-2024) were assessed. A predicted risk of index surgical aortic valve mortality model, incorporating the Fried frailty index, was fitted to simulate the Society of Thoracic Surgeons risk model (AUC=0.850). TAVI outcomes were stratified by predicted risk of mortality. Results A cohort of 6,921 patients ≤65 years received TAVI. The median age was 60 years, 81.3% were elective, and 9.1% bicuspid. The average predicted risk was 4.3%, with 66.2% of patients having a predicted risk 4%. A total of 50 patients (0.7%) died within 30-days of the index procedure. Early complications included 41 (0.6%) emergent sternotomies, 182 (2.6%) unplanned coronary interventions, 32 (0.5%) femoral artery repairs, 77 (1.0%) strokes, and 485 (4.1%) new permanent pacemakers. With a median follow-up of 3.3 years, 5-year survival was 88% in low and intermediate risk patients and 78% in the high-risk cohort (8% predicted). Conclusions Most contemporary patients ≤65 years receiving TAVI outside of existing guidelines are of low surgical risk. These findings, in combination with the cumulative longitudinal risks of TAVI, highlight the need for careful heart team discussions for most young patients requiring AVR.
Mehaffey et al. (Wed,) reported a other. In patients ≤65 years undergoing TAVI, 5-year survival was 88% in low/intermediate risk and 78% in high-risk groups, with 0.7% 30-day mortality.