Abstract
Transcatheter Aortic valve Replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement for patients considered at high or prohibitive operative risk. It is widely known the short and mid-term outcomes, however, is limited about long-term outcomes in according to age. The aim of this study was to determine the survival and the clinical outcomes on based of age. after TAVR with the CoreValve prosthesis.
Methods
From April 2008 to December 2017, the CoreValve and Sapiens 3 prosthesis were implanted in 667 patients with symptomatic severe aortic stenosis with deemed high risk on base to age, <80 years and ≥80 years old
Results
The mean age in patients <80 compared with ≥80 years, was 73.6±7 vs. 83.4±2.8 years and the logistic EuroSCORE and STS score were 16.3±11% vs. 18.1±11%. In-hospital mortality was 3.4%, and the combined endpoint of death, vascular complications, myocardial infarction, majopr bleeding or stroke had a rate of 18.3%. The late mortality (beyond 30 days) was 40.5%. When compared both groups, there were no differences for the presence of threatening bleeding 3.5% vs. 3.6% (HR = 1.033 [IC95% 0.452–2.360], p=0.557), myocardial infarction4.2% vs. 2.9% (HR = 0.67 [IC95% 0.290–1,530], p=0.0.226), stroke 8.9% vs. 9.4% (HR = 1.067 [IC95% 0.625–1.821], p=0.814) and mortality 44.5% vs. 41.1% (HR=0.971388 [IC95% 0.639–1.188], p=0.214) and there was difference in between groups in hospitalizations for heart failure 13.8% vs. 7.7% (HR = 1.374 [IC95% 1.037–1.821], p=0.008. Survival at 1, 2, 3, 4, 5 were similar in both groups (86.9% vs. 89.8%, 78.4 vs. 78.3%, 65.5 vs. 72.5%, 57.9% vs. 62.8% and 51.1 vs. 52.8%>; log Rank 0.992, p=0.319), respectively, after a mean follow-up of 43.9±27 months.
Conclusions
TAVR is associated with significant survival benefit throughout 3.2 years of follow-up. Survival during follow-up was similar in patients with <80 compared with ≥80 years old.
CV3 MECHANICALLY EXPANDED VERSUS SELF-EXPANDING TRANSCATHETER AORTIC VALVE REPLACEMENT IN HIGH-RISK PATIENTS WITH AORTIC STENOSIS: A BUDGET IMPACT ANALYSIS
