Aims
To evaluate the long-term incidence of structural valve deterioration (SVD) in patients
who underwent transcatheter aortic valve implantation (TAVI).
Method and Results
Between 2008 and 2018, 693 underwent TAVI at two centres. Four hundred and twenty-one
(421) patients (mean age 83.6±6.0 yrs) survived for ≥2 years post TAVI and had at
least two consecutive transthoracic echocardiographies (TTEs) with the latest TTE
no less than 2 years after TAVI, and were therefore included in the analysis for SVD.
Median follow-up was 4.7 (3.6–6.0) years and median echocardiography follow-up 3 (3.0–4.0)
years. All-cause mortality was 30.9% (130) with a median time to death of 4.1 (3.0–5.6)
years. The cumulative incidence of SVD increased from 1.7% (95% CI, 0.4–2.9) at 3
years to 3.5% (95% CI, 1.5–5.8) at 5 years and 4.7% (95% CI, 1.6–7.9) at 10 years.
The overall median time to SVD was 3 (2–4) years.
Twelve (12) patients demonstrated SVD stage 2, and 1 patient stage 3. No SVD required
re-intervention. All other patients showed no significant changes in valve parameters
over time.
Conclusions
Structural valve deterioration is an uncommon event, occurring in 5% over a total
follow-up of 10 years. Most patients show stable valve parameters. However, the analysis
is limited by the loss of follow-up (owing to patient mortality), which renders extrapolation
of the data to a younger patient population difficult.
Keywords
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Article info
Publication history
Published online: November 11, 2022
Accepted:
October 9,
2022
Received in revised form:
August 20,
2022
Received:
March 4,
2022
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
