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Three-year outcomes after transcatheter aortic valve implantation with the CoreValve prosthesis

Michael Gotzmann1, Anna Czauderna1, Tobias Hehnen1

  • 1BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.

The American Journal of Cardiology
|July 7, 2014
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis shows improved symptoms and outcomes after three years. However, complications like aortic regurgitation and prosthesis issues warrant consideration.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Prosthetic Heart Valves

Background:

  • Long-term outcomes of the CoreValve prosthesis following transcatheter aortic valve implantation (TAVI) are not well-established.
  • Severe aortic stenosis necessitates effective treatment options for improved patient survival and quality of life.

Purpose of the Study:

  • To evaluate the 3-year clinical and hemodynamic results of the CoreValve prosthesis used in TAVI.
  • To assess mortality, morbidity, and functional status following TAVI for severe aortic stenosis.

Main Methods:

  • A prospective study involving 150 consecutive patients with severe aortic stenosis undergoing TAVI with the CoreValve prosthesis.
  • Primary endpoint: all-cause mortality. Secondary endpoints: cardiovascular death, prosthesis-related mortality/morbidity, and New York Heart Association (NYHA) functional class.

Main Results:

  • All-cause mortality at 1, 2, and 3 years was 25%, 32%, and 41%, respectively. Cardiovascular mortality was 14%, 21%, and 27% at the same time points.
  • Significant improvement in NYHA class: from 95% in class III/IV pre-TAVI to 33-39% in surviving patients at 1-3 years.
  • Moderate to severe aortic regurgitation (AR) occurred in 15% initially, with slight worsening in 13% by 3 years. No new severe AR. Prosthesis-related issues occurred in 1.5% annually.

Conclusions:

  • TAVI with the CoreValve prosthesis demonstrates favorable 3-year effects on symptoms and outcomes in severe aortic stenosis.
  • The benefits are tempered by the occurrence of side effects, including aortic regurgitation and prosthesis-related complications.

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