Percutaneous bioprosthetic aortic valve durability: results a single center after ten years of follow-up ago

Abstract   The durability of transcatheter heart valves and long-term clinical outcomes are unknown. The aim of this study was to evaluate clinical and hemodynamic outcomes 10 years after Transcatheter Aortic Valve Implantation (TAVI). Methods Between April 2008 and December 2011, 230 patients underwent TAVI for the treatment of severe symptomatic aortic stenosis with the auto-expandable prosthesis. Results The mean age, logistic EuroSCORE and STS score were 79.3±6.4 years, 19.8±13% and 6.8±5% respectively. Mean aortic valve gradient decreased from 49.8±15 mm Hg to 8.6±3.8 mmHg after TAVI, to 11.1±9 mm Hg at 5 years, and 25.7±12 mmHg at 7 years (p for post-TAVI trend 0.03). Mean aortic valve area increased from 0.63±0.16 cm2 to 1.57±0.3cm2 after TAVI to 1.48±0.2 at 5 years and 0.87±0.3 cm2 at 7 years (p for post-TAVI trend 0.01). Mean left ventricular ejection fraction increased from 61.1±15% to 65.5±11% after TAVI, to 58.2±17% at 5 years and 57.2±8% at 7 years (p for post-TAVI trend 0.001). The total mortality after a mean of 53±34 months was 73% and 34.4% was cardiovascular mortality. Survival rates at 1 to 10 years were at 86%, 75.4%, 64.9%, 59.6%, 52.6%, 33.1%, 24.9%, 20.7%, 10.4% and 10.4% respectively. Only 4 patients had severe prosthetic valve dysfunction (severe stenosis and moderate-severe transvalvular regurgitation). Median survival time after TAVI was 6 years (95% confidence interval [CI]: 5.89 to 6.28), and the risk of death was significantly increased in patients with frailty (adjusted hazard ratio [HR]: 1.874; 95% CI: 1.028 to 3.418), p=0.040, Charlson index [HR=1.212 (95% CI: 1.094–1.341), p<0.001], and age [HR=1.03; (95% CI: 1.001–1.062), p=0.049]. Conclusions In our center, the transcatheter aortic valve implantation in patients at high surgical risk, presented favourable clinical outcomes and hemodynamic performance after ten years of follow-up. Funding Acknowledgement Type of funding sources: None.