Transcatheter aortic valve replacement in high-risk patients demonstrated an 8-year overall mortality of 69.2%, with low rates of structural valve deterioration (3.3%) and bioprosthetic valve failure (2.4%).
Observational (n=795)
No
In elderly and high-risk patients undergoing transfemoral TAVR, long-term follow-up up to 8 years demonstrates high expected all-cause mortality but low rates of structural valve deterioration and bioprosthetic valve failure.
BackgroundTranscatheter aortic valve replacement (TAVR) has become the standard of care in the majority of patients with symptomatic severe aortic stenosis. Data on long-term mortality and durability of transcatheter heart valves (THVs) beyond 5 years are limited. Our study aimed to assess elderly and high-risk patients’ long-term outcomes treated with TAVR in a prospective single-centre registry focusing on the durability of THVs.MethodsWe included 795 patients with severe calcific aortic stenosis treated by transfemoral TAVR between 2006 and 2011. Echocardiography was performed at baseline; discharge; 1 year; and afterward, annually, until the longest available follow-up. Mortality rates were estimated for 1, 5, 6, 7, and 8 years. The rates of structural valve deterioration (SVD) and bioprosthetic valve failure (BVF) were assessed in accordance with consensus definitions. Outcome measures were adjudicated according to Valve Academic Research Consortium-2 (VARC-2).ResultsMedian (interquartile range) follow-up time was 1345 (316; 2015) days. One-year, 5-year, 6-year, 7-year, and 8-year overall mortality was 25.4%, 59.0%, 64.6%, 67.9%, and 69.2%, respectively. At 8 years, no significant differences in mortality were found comparing self-expanding vs balloon-expandable valves (69.5% vs 68.0%, P = 0.709) and postdilatation (PD) vs no-PD (69.4% vs 69.2%, P = 0.363). SVD was detected in 26 patients (3.3%), and 19 (2.4%) of the 795 patients had evidence of BVF during follow-up.ConclusionsOur study demonstrates good long-term results for high-risk patients who were alive up to 8 years after TAVR.
Haußig et al. (Tue,) conducted a observational in severe calcific aortic stenosis (n=795). Transcatheter aortic valve replacement (TAVR) was evaluated on 8-year overall mortality. Transcatheter aortic valve replacement in high-risk patients demonstrated an 8-year overall mortality of 69.2%, with low rates of structural valve deterioration (3.3%) and bioprosthetic valve failure (2.4%).
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