Key result
TAVI in nonagenarians yields similar in-hospital mortality compared to younger patients.
Why the study?
The application of TAVI in nonagenarians remains controversial due to limited data in this very elderly population.
Does TAVI result in comparable mortality and complication rates in nonagenarians compared to younger patients with symptomatic severe aortic stenosis?
Cohort (n=265)
No
Does TAVI result in comparable mortality and complication rates in nonagenarians compared to younger patients with symptomatic severe aortic stenosis?
Absolute Event Rate: 7.9% vs 5.3%
p-value: p=0.861
TAVI is a safe and effective therapeutic option for nonagenarians with symptomatic severe aortic stenosis, showing clinical outcomes and mortality rates comparable to younger patients up to one year.
May support TAVI feasibility in selected nonagenarians; extends observational data but leaves open need for randomized confirmation.
Background: Aortic Stenosis (AS) is prevalent among elderly individuals and is associated with high mortality when untreated.Transcatheter Aortic Valve Implantation (TAVI) has emerged as a viable therapeutic alternative, particularly for patients with surgical contraindications.However, its application in nonagenarians remains controversial due to limited data in this very elderly population.Objective: To evaluate clinical outcomes in nonagenarian patients undergoing TAVI at a private quaternary hospital, with emphasis on mortality and in-hospital as well as one-year complications.Methods: A retrospective cohort study with prospective follow-up was conducted between 2009 and 2023.A total of 265 patients with symptomatic severe AS who underwent TAVI were included, of whom 40 were nonagenarians (≥ 89 years).Data were obtained from an institutional database and from the Brazilian Registry of Aortic Bioprosthesis Implantation by Catheter -New Technologies (RIBAC-NT).Comparisons between nonagenarians and younger patients were performed using the Student's t-test for continuous variables and the chi-square (χ²) test for categorical variables.A p-value < 0.05 was considered statistically significant.Results: Among nonagenarians, 55% were female, 72.5% had hypertension, and 95% had chronic kidney disease.The technical success rate was 55%.Major complications included permanent pacemaker implantation (35%) and adverse events (45%).In-hospital mortality was 7.9%, with no statistically significant differences at 30 days (p = 0.40), 6 months (p = 0.35), and one year (p = 0.06) compared to younger patients.Conclusion: TAVI proved to be a safe and effective therapeutic option in nonagenarians, showing clinical outcomes comparable to those of younger individuals.
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Mattos et al. (2026) conducted a cohort in Symptomatic severe Aortic Stenosis (n=265). Advanced age (≥ 89 years) undergoing TAVI vs. Age < 89 years undergoing TAVI was evaluated on In-hospital mortality (p=0.861). Transcatheter aortic valve implantation in nonagenarians resulted in an in-hospital mortality rate of 7.9%, which was not significantly different from the 5.3% observed in younger patients (p=0.861).
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