Early and mid-term results of transcatheter aortic valve implantation and valve durability assessment
- 19 April 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Heart and Vessels
- Vol. 36 (10), 1566-1573
- https://doi.org/10.1007/s00380-021-01842-x
Abstract
This study aimed to evaluate the early and mid-term outcomes of transcatheter aortic valve implantation (TAVI) and to assess valve durability. A total of 146 consecutive patients who underwent TAVI for severe aortic stenosis between October 2013 and August 2018 were retrospectively reviewed. All patients (mean age, 84 ± 6 years; age range 53–98 years; 42 males [28.7%]) had multiple comorbidities, with a mean logistic EuroSCORE of 30.9 ± 17.4%. Eighteen patients (12.3%) were aged 90 years or over. Five in-hospital deaths (3.4%) occurred, and 36 patients (24.7%) experienced major TAVI-related complications. With the transfemoral approach, 10 patients had major vascular complications, which mostly occurred with first-generation devices (n = 9) but less commonly with new-generation low-profile devices (P = 0.0078). During a follow-up period of 580 ± 450 (11–1738) days, 29 late deaths occurred. The survival rate was 86.0%, 78.0%, and 61.7% at 1, 2, and 3 years, respectively. Multivariate Cox hazard regression analysis revealed that more-than-moderate tricuspid regurgitation was the only independent risk factor for late deaths due to any cause (hazard ratio, 3.145; 95% confidence interval, 1.129–8.762; P = 0.0283). No statistically significant differences between post-TAVI before discharge from the hospital and at 4 years after TAVI were observed with respect to aortic valve area (1.76 ± 0.49 cm2 vs. 1.64 ± 0.38 cm2; P = 0.1871) and mean pressure gradient (10.0 ± 4.6 mmHg vs. 7.9 ± 3.3 mmHg; P = 0.5032). TAVI was a feasible method with acceptable early and mid-term outcomes and valve durability for at least 4 years in poor-risk patients. Further close follow-up is essential to evaluate late outcomes and valve durability.Keywords
This publication has 22 references indexed in Scilit:
- Effect of Tricuspid Regurgitation and the Right Heart on Survival After Transcatheter Aortic Valve ReplacementCirculation: Cardiovascular Interventions, 2015
- 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): a randomised controlled trialThe Lancet, 2015
- Prevalence and impact of preoperative moderate/severe tricuspid regurgitation on patients undergoing transcatheter aortic valve replacementCatheterization and Cardiovascular Interventions, 2014
- A 3-Center Comparison of 1-Year Mortality Outcomes Between Transcatheter Aortic Valve Implantation and Surgical Aortic Valve Replacement on the Basis of Propensity Score Matching Among Intermediate-Risk Surgical PatientsJACC: Cardiovascular Interventions, 2013
- Transcatheter Aortic Valve Implantation in Patients With Concomitant Mitral and Tricuspid RegurgitationThe Annals of Thoracic Surgery, 2013
- Two-Year Outcomes after Transcatheter or Surgical Aortic-Valve ReplacementThe New England Journal of Medicine, 2012
- Outcomes After Transcatheter Aortic Valve Implantation: Transfemoral Versus Transapical ApproachThe Annals of Thoracic Surgery, 2011
- Evidence of leaflet injury during percutaneous aortic valve deploymentEuropean Journal of Cardio-Thoracic Surgery, 2011
- Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk PatientsThe New England Journal of Medicine, 2011
- Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo SurgeryThe New England Journal of Medicine, 2010