Key result
Early-era TAVR linked to ~2-fold higher mortality compared to late-era procedures.
Why the study?
Estimated lifespan following TAVR is key for lifelong management decisions in severe symptomatic AS, motivating an assessment of contemporary lifespan and associated factors.
Does transcatheter aortic valve replacement in a contemporary era improve long-term survival compared to an early era in patients with symptomatic severe aortic stenosis?
Cohort (n=6,191)
Yes
Does transcatheter aortic valve replacement in a contemporary era improve long-term survival compared to an early era in patients with symptomatic severe aortic stenosis?
Hazard Ratio: 2 (95% CI 1.8–2.2)
Absolute Event Rate: 39% vs 71%
p-value: p=<0.001
Survival after transcatheter aortic valve replacement has markedly improved over the past decade, demonstrating that patients aged under 80 years have a post-procedural life expectancy exceeding 10 years, which warrants considering future valve durability and reintervention options during initial Heart Team discussions.
Contemporary TAVR survival gains may reflect advances; leaves open durability questions for patients <80 with >10-year expectancy.
Background: The estimated lifespan following transcatheter aortic valve replacement (TAVR) is the key in the decision-making process of lifelong management of patients with severe symptomatic aortic stenosis (AS). We aimed to assess the contemporary lifespan and associated factors in patients with severe AS undergoing TAVR. Methods: We performed a retrospective cohort study of patients who underwent TAVR at the 4 largest centers in Israel between July 2008 and March 2023. Mortality predictors were assessed using multivariable Cox regression analysis. Results: < 0.001], with an 8-year survival of 39 and 71%, respectively. Using an age threshold of ≥80 years, defined using spline analysis the 8-year survival in the early vs. late eras was 37 vs. 47% among older patients and 66 vs. 82% among younger patients. Conclusions: Lifespan following successful TAVR has markedly improved over the past decade across age groups. Notably, patients younger than 80 years, at the time of TAVR exhibit an estimated survival exceeding 10 years. These findings should be integrated into Heart Team decision-making for optimal lifelong management of AS.
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Zornitzki et al. (2025) conducted a cohort in Severe symptomatic aortic stenosis (n=6,191). Early TAVR period (2008-2015) vs. Late TAVR period (2016-2023) was evaluated on 8-year survival and long-term mortality (HR 2.0, 95% CI 1.8-2.2, p=<0.001). Patients undergoing TAVR in the early period (2008-2015) had a significantly higher risk of mortality compared to those in the late period (2016-2023) (HR 2.0), with 8-year survival improving from 39% to 71% over time.
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