Long-term Follow-up After Transcatheter Aortic Valve Replacement

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomedical Engineering

Background:

• Transcatheter aortic valve replacement (TAVR) is standard for symptomatic severe aortic stenosis.
• Limited data exists on transcatheter heart valve (THV) durability beyond 5 years.
• This study focuses on long-term outcomes and THV durability in elderly, high-risk patients.

Purpose of the Study:

• To assess long-term mortality and THV durability after TAVR.
• To evaluate outcomes in a prospective single-centre registry of high-risk patients.
• To provide data beyond 5 years for TAVR efficacy.

Main Methods:

• Included 795 patients with severe calcific aortic stenosis treated with transfemoral TAVR (2006-2011).
• Echocardiography performed at baseline, discharge, 1 year, and annually thereafter.
• Mortality, structural valve deterioration (SVD), and bioprosthetic valve failure (BVF) assessed up to 8 years per VARC-2 criteria.

Main Results:

• Median follow-up was 1345 days.
• 8-year overall mortality was 69.2%.
• No significant mortality differences between valve types or postdilatation use; SVD in 3.3%, BVF in 2.4%.

Conclusions:

• TAVR demonstrates favorable long-term results for high-risk patients.
• Good durability of THVs observed up to 8 years post-procedure.
• Supports TAVR as a viable long-term option for severe aortic stenosis in high-risk individuals.