Contemporary Life Expectancy Following Transfemoral Transcatheter Aortic Valve Replacement-Data From a National...

Area of Science:

• Cardiology
• Interventional Cardiology
• Geriatric Cardiology

Background:

• Lifespan estimation is crucial for managing severe symptomatic aortic stenosis (AS) patients post-transcatheter aortic valve replacement (TAVR).
• Contemporary survival data and influencing factors in TAVR recipients are essential for long-term patient care strategies.

Purpose of the Study:

• To evaluate the current lifespan and identify predictors of mortality in patients with severe AS undergoing TAVR.
• To analyze temporal trends in survival rates following TAVR over different eras.

Main Methods:

• Retrospective cohort study involving 6191 patients across 4 major Israeli centers from July 2008 to March 2023.
• Multivariable Cox regression analysis was employed to determine mortality predictors.
• Patients were stratified into early (2008-2015) and late (2016-2023) TAVR eras for temporal trend assessment.

Main Results:

• Overall 5- and 10-year survival rates were 70% and 42%, respectively, with a median follow-up of 5.9 years.
• Patients in the late TAVR era demonstrated significantly better survival than those in the early era (HR 2.0, p < 0.001).
• Eight-year survival improved from 39% in the early era to 71% in the late era; younger patients (<80 years) showed markedly higher survival rates in the late era (82% vs. 66% in early era).

Conclusions:

• Survival following TAVR has substantially improved over the last decade across all age groups.
• Patients younger than 80 years at the time of TAVR have an estimated survival exceeding 10 years.
• These findings underscore the importance of integrating contemporary lifespan data into Heart Team decision-making for optimal lifelong management of severe AS.