Long-term Follow-up After Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis

Abstract

Introduction and objectives: Transcatheter aortic valve implantation is used as an alternative to surgical valve replacement in patients with severe aortic stenosis who are considered high-surgical-risk or inoperable. Two of the main areas of uncertainty in this field are valve durability and long-term survival.

Methods: This prospective single-center registry study from a tertiary hospital included all consecutive patients who underwent percutaneous aortic valve implantation between 2008 and 2012. Clinical follow-up lasted a minimum of 2.5 years and a maximum of 6.5 years. Valve Academic Research Consortium-2 definitions were used.

Results: Seventy-nine patients were included, with an immediate success rate of 94.9%. The median survival was 47.6 months (95% confidence intervals, 37.4-57.9 months), ie, 4 years. One quarter of deaths occurred in the first month, and most were of cardiovascular cause. After the first month, most deaths were due to noncardiovascular causes. The mean values of valve gradients did not increase during follow-up. The cumulative rate of prosthetic valve dysfunction was 15.3%, with no cases of repeat valve replacement.

Conclusions: Half of the patients with aortic stenosis who underwent transcatheter aortic valve implantation were alive 4 years after the procedure. There was a 15.3% prosthetic valve dysfunction rate in cumulative follow-up, with no cases of repeat valve replacement.

Keywords: Aortic stenosis; Definiciones Valve Academic Research Consortium; Estenosis aórtica; Implante percutáneo de válvula aórtica; Reemplazo percutáneo de válvula aórtica; Transcatheter aortic valve implantation; Transcatheter aortic valve replacement; Valve Academic Research Consortium definitions; Valvular heart disease; Valvulopatía.