Key result
Transcatheter aortic valve implantation in very elderly patients (>85 years) with severe aortic stenosis resulted in an estimated two-year overall survival rate of 71%.
Why the study?
Does transcatheter aortic valve implantation provide acceptable safety and survival outcomes in very elderly patients (>85 years) with severe and symptomatic aortic stenosis?
Observational (n=160)
Yes
Does transcatheter aortic valve implantation provide acceptable safety and survival outcomes in very elderly patients (>85 years) with severe and symptomatic aortic stenosis?
TAVI demonstrates acceptable procedural success and medium-term survival in very elderly patients (>85 years) with severe symptomatic aortic stenosis.
OBJECTIVE: To evaluate immediate transcatheter aortic valve implantation (TAVI) results and medium-term follow-up in very elderly patients with severe and symptomatic aortic stenosis (AS). METHODS: This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly (> 85 years) patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rates from any cause at two years. RESULTS: The study included 160 consecutive patients with a mean age of 87 ± 2.1 years (range from 85 to 94 years) and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 (35.6%) patients scoring ≥ 20%. Procedural success rate was 97.5%, with 25 (15.6%) patients experiencing acute complications with major bleeding (the most frequent). Global mortality rate during hospitalization was 8.8% (n = 14) and 30-day mortality rate was 10% (n = 16). Median follow up period was 252.24 ± 232.17 days. During the follow-up period, 28 (17.5%) patients died (17 of them due to cardiac causes). The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique variable associated with overall mortality. CONCLUSIONS: TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients.
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Pascual et al. (2015) conducted an observational in severe and symptomatic aortic stenosis (n=160). Transcatheter aortic valve implantation (TAVI) was evaluated on death rates from any cause at two years. Transcatheter aortic valve implantation in very elderly patients (>85 years) with severe aortic stenosis resulted in an estimated two-year overall survival rate of 71%.
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