Long term Transcatheter Aortic Valve Durability Data from the UK TAVI .pdf (853.65 kB)
Long-term durability of transcatheter aortic valve prostheses
journal contribution
posted on 2023-06-09, 17:56 authored by Daniel J Blackman, Smriti Saraf, Philip A MacCarthy, Aung Myat, Simon G Anderson, Christopher J Malkin, Michael S Cunnington, Kathryn Somers, Paul Brennan, Ganesh Manoharan, Jessica Parker, Omar Aldalati, Stephen J Brecker, Cameron Dowling, Stephen P Hoole, Stephen Dorman, Michael Mullen, Simon Kennon, Melanie Jerrum, Pavan Chandrala, David H Roberts, Justin Tay, Sagar N Doshi, Peter F Ludman, Timothy A Fairbairn, Joanne Crowe, Richard D Levy, Adrian P Banning, Neil Ruparelia, Mark S Spence, David Hildick-SmithBackground: 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.
History
Publication status
- Published
File Version
- Accepted version
Journal
Journal of the American College of CardiologyISSN
0735-1097Publisher
ElsevierExternal DOI
Issue
5Volume
73Page range
537-545Department affiliated with
- BSMS Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2019-05-31First Open Access (FOA) Date
2020-02-19First Compliant Deposit (FCD) Date
2019-05-29Usage metrics
Categories
No categories selectedKeywords
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC