TY - JOUR
TI - Long-Term Outcomes and Valve Performance in Patients Undergoing
Transcatheter Aortic Valve Implantation
AU - Stathogiannis, Konstantinos
AU - Synetos, Andreas
AU - Latsios, George and
AU - Karanasos, Antonios
AU - Trantalis, George
AU - Toskas, Pantelis and
AU - Drakopoulou, Maria
AU - Xanthopoulou, Maria
AU - Karmpalioti, Maria and
AU - Simopoulou, Chryssa
AU - Soulaidopoulos, Stergios
AU - Oikonomou, George
AU - and Benetos, Georgios
AU - Tsalamandris, Sotirios
AU - Kosmas, Ilias and
AU - Voudris, Vasilis
AU - Mastrokostopoulos, Antonios
AU - Katsimagklis,
AU - George
AU - Halvatsiotis, Panos
AU - Deftereos, Spyridon
AU - Tsioufis,
AU - Costas
AU - Toutouzas, Konstantinos
JO - AMERICAN JOURNAL OF CARDIOLOGY
PY - 2021
VL - 147
TODO - null
SP - 80-87
PB - EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
SN - 0002-9149
TODO - 10.1016/j.amjcard.2021.02.006
TODO - null
TODO - Transcatheter aortic valve implantation (TAVI) is an established method
for treating patients with aortic valve stenosis. We sought to determine
the long-term clinical outcomes and performance of a self-expanding
bioprosthesis beyond 5 years. Consecutive patients scheduled for TAVI
were included in the analysis. Primary end points were all-cause and
cardiovascular mortality, structural valve deterioration (SVD) and
bioprosthetic valve failure (BVF), based on the VARC-2 criteria and
consensus statement by ESC/EAPCI. The study prospectively evaluated 273
patients (80.61 +/- 7.00 years old, 47% females) who underwent TAVI
with CoreValve/Evolut-R (Medtronic Inc.). The median follow-up duration
was 5 years (interquartile range: 2.9 to 6; longest: 8 years). At 1, 5,
and 8 years, estimated survival rates were 89.0%, 61.1%, and 56.0%,
respectively, while cardiovascular mortality was 8% at the end of
follow-up. Regarding valve performance, 5% of patients had early BVF
and 1% had late BVF. Concerning SVD, 16 patients (6% of the total
population) had moderate SVD (91% had an increase in mean gradient),
with no severe SVD cases. Five patients with SVD died during follow-up.
Actual analysis of the 8-year cumulative incidence of function of
moderate SVD was 5.9% (2.5% to 16.2%). At multivariate analysis, the
factor that emerged as an independent predictor for future SVD, was
smaller bioprosthetic valve size (HR 0.58, 95% CI 0.41 to 0.82, p =
0.002). Long-term evaluation beyond 5 years after TAVI with a
self-expanding bioprosthesis demonstrated low rates of cardiovascular
mortality and structural valve deterioration. Valve size was an
independent predictor for SVD. (C) 2021 Elsevier Inc. All rights
reserved.
ER -