Long-term durability of transcatheter aortic valve prostheses

Blackman, Daniel J, Saraf, Smriti, MacCarthy, Philip A, Myat, Aung, Anderson, Simon G, Malkin, Christopher J, Cunnington, Michael S, Somers, Kathryn, Brennan, Paul, Manoharan, Ganesh, Parker, Jessica, Aldalati, Omar, Brecker, Stephen J, Dowling, Cameron, Hoole, Stephen P, Dorman, Stephen, Mullen, Michael, Kennon, Simon, Jerrum, Melanie, Chandrala, Pavan, Roberts, David H, Tay, Justin, Doshi, Sagar N, Ludman, Peter F, Fairbairn, Timothy A, Crowe, Joanne, Levy, Richard D, Banning, Adrian P, Ruparelia, Neil, Spence, Mark S and Hildick-Smith, David (2019) Long-term durability of transcatheter aortic valve prostheses. Journal of the American College of Cardiology, 73 (5). pp. 537-545. ISSN 0735-1097

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Abstract

Background: Very little is known about long-term valve durability after trans-catheter aortic
valve implantation (TAVI).

Objectives: To evaluate the incidence of structural valve degeneration 5 to 10 years post
procedure.

Methods:
Demographic, procedural, and in-hospital outcome data on patients who underwent TAVI from
2007-2011 were obtained from the UK TAVI Registry. Patients in whom echocardiographic data
were available both at baseline and ≥5 years post-TAVI were included. Haemodynamic
structural valve degeneration (SVD) was determined according to European task force
committee guidelines.

Results:
241 patients (79.3±7.5 years; 46.4% female) with paired post-procedure and late
echocardiographic follow-up (median 5.8 years, range 5 - 10 years) were included. 150 patients
(64.1%) were treated with a CoreValve and 80 (34.2%) with an Edwards valve. Peak aortic
valve gradient at follow-up was lower than post-procedure (17.2 vs 19.4 mmHg, p=0.003). More
patients had none/trivial aortic regurgitation (AR) at follow-up (47.4% vs 32.9%, p=0.055), and
fewer had mild AR (41.7% vs 57.7%, p=0.02). There was 1 case (0.4%) of severe SVD 5.3
years after implantation (new severe AR). There were 21 cases (8.7%) of moderate SVD (mean
6.1 years post-implantation; range 4.9- 8.6 years). 12 of these (57%) were due to new AR and 9
(43%) to restenosis.
4

Conclusions:
Long-term transcatheter aortic valve function is excellent. In our study, 91% of patients
remained free of structural valve deterioration between 5 and 10 years post-implantation. The
incidence of severe structural valve degeneration was less than 1%. Moderate structural valve
degeneration occurred in one in twelve patients.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Clinical and Experimental Medicine
Depositing User: Ellena Adams
Date Deposited: 31 May 2019 11:13
Last Modified: 01 Jul 2019 13:31
URI: http://sro.sussex.ac.uk/id/eprint/84037

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