Related Experiment Video
Updated: May 31, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Potentially futile outcome after uncomplicated TAVI: Insights from the TRITAVI registry
Fabrizio D'Ascenzo1, Ovidio de Filippo1, Francesco Pelliccia2
1Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy.
Background:
Patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) are still exposed to a not negligible risk of death during the first year after the procedure, despite a not-complicated procedure. However, few data are still available about timing and kind of death after the procedure.
Methods:
Transfusion requirements in transcatheter aortic valve implantation (TRITAVI; NCT03740425) is an international, investigator-initiated registry designed to collect data on patients with symptomatic severe aortic stenosis undergoing TAVI at 18 European sites. The primary end point of the study was all-cause death occurring in patients between 30 days and 1 year without major peri‑procedural complications (major vascular complications, stage 2 to 3 acute kidney injury (AKI) and transfusions) during the procedure.
Results:
A total of 11,246 patients were included (mean age 82 years; 52% female). Among them, 454 (4%) died between 1 and 12 months without major peri‑procedural complications. Patients who died were also elderly (mean age 82 years) and 50% were female. Of these, 78 (0.7%) died for cardiovascular reasons, while 376 (3.3%) died for noncardiovascular reasons. COPD (HR: 1.35, 95% CI: 1.05-1.73, P = .002), Atrial Fibrillation (HR: 1.46, 95% CI: 1.16-1.84, P = .001), severe Chronic Kidney Disease (CKD) (HR: 1.70, 95% CI: 1.10-2.62, P = .018), moderate and severe reduction of LVEF (respectively HR: 1.42, 95% CI: 1.07-1.90, P = .017 and HR 1.62, 95% CI 1.17-2.23, P = .003) were associated with and increased risk of the primary end point. At competitive risk analysis, risk of non-CV death appeared to be more relevant and to steadily increase across the year, while risk of CV death was lower. Consistently, baseline creatinine (HR: 1.2, 95% CI: 1.1-1.4, P = .002) and AF (HR: 1.4, 95% CI: 1.1-1.8, P = .008) related to increased risk of non-CV death, while higher baseline LVEF related to lower risk (HR: 0.9, 95% CI: 0.8-0.99, P < .001).
Conclusion:
Risk of death between 30 days and 1 year after noncomplicated TAVI is not negligible even for patients without major peri‑procedural complications. It appears mainly driven by non-CV reasons and predicted by baseline renal function, baseline LVEF, and atrial fibrillation.
