Four-year durability of clinical and haemodynamic outcomes of transcatheter aortic valve implantation with the self-expanding CoreValve

• Published in: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology Vol. 12; no. 8; p. e1031
• Main Authors: Gulino, Simona, Barbanti, Marco, Deste, Wanda, Immè, Sebastiano, Aruta, Patrizia, Bottari, Vera, Benvenuto, Emanuele, Tamburino, Claudia, Di Landro, Alessio, Liberto, Daria, Santonoceto, Letizia, Sicuso, Rita, Di Stefano, Daniele, Todaro, Denise, Di Simone, Emanuela, Indelicato, Antonino, Giannazzo, Daniela, Sgroi, Carmelo, Tamburino, Corrado
• Format: Journal Article
• Language: English
• Published: France 10-10-2016
• Subjects: Aged; Aged, 80 and over; Aortic Valve Insufficiency - diagnostic imaging; Aortic Valve Insufficiency - epidemiology; Aortic Valve Stenosis - surgery; Echocardiography; Female; Follow-Up Studies; Heart Valve Prosthesis; Hemodynamics; Humans; Male; Postoperative Complications - diagnostic imaging; Postoperative Complications - epidemiology; Prosthesis Design; Prosthesis Failure; Severity of Illness Index; Survival Rate; Transcatheter Aortic Valve Replacement - methods; Treatment Outcome
• ISSN: 1969-6213
• DOI: 10.4244/EIJV15M10_08

Long-term data on the durability of currently available transcatheter heart valves are limited. We sought to assess four-year clinical and echocardiographic outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis.
Between June 2007 and February 2014, 450 consecutive patients with symptomatic severe aortic stenosis underwent TAVI in our institution. For the purposes of this study, we included only those patients undergoing successful TAVI with the CoreValve prosthesis who had a minimum follow-up of four years (n=125). Survival rates at one, two, three and four years were 83.2, 76.8, 73.6 and 66.3%, respectively. Aortic regurgitation was a common finding after the procedure, especially due to paravalvular regurgitation (PVR), which was observed in the majority of patients (71.5%), mostly mild (52.0%). Progression from mild acute PVR to moderate PVR at four-year follow-up was reported in three patients. No cases of severe PVR were observed. Prosthetic valve failure was reported in four patients (3.2%).
Our study demonstrates that favourable outcomes after successful TAVI are associated with sustained clinical and functional cardiovascular benefits up to four-year follow-up. Signs of moderate prosthetic valve failure are present only in a small percentage of patients.