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Multicenter Study
. 2026 Jan 19;22(2):e90-e100.
doi: 10.4244/EIJ-D-25-00575.

Predictors of long-term structural valve deterioration and failure after transcatheter aortic valve implantation

Tullio Palmerini  1 , Francesco Saia  1 , Antonio Giulio Bruno  1 , Marianna Adamo  2 , Giuliano Chizzola  3 , Mauro Massussi  3 , Marco De Carlo  4 , Giulia Costa  4 , Marco Angelillis  4 , Luca Testa  5 , Francesco Bedogni  5 , Barbara Bellini  6 , Matteo Montorfano  6   7 , Nevio Taglieri  1 , Gabriele Ghetti  1 , Mateusz Orzalkiewicz  1 , Giuseppe Bruschi  8 , Bruno Merlanti  8 , Erica Ferrara  9 , Arnaldo Poli  9 , Francesco De Felice  10 , Carmine Musto  10 , Marco Foroni  1 , Laura Lombardi  1 , Alex Conte  1 , Damiano Regazzoli  11 , Adele Pierri  12 , Tiziana Attisano  12 , Nazzareno Galiè  1
Affiliations
Multicenter Study

Predictors of long-term structural valve deterioration and failure after transcatheter aortic valve implantation

Tullio Palmerini et al. EuroIntervention. .

Abstract

Background: Independent predictors and prognostic correlates of structural valve deterioration (SVD) after transcatheter aortic valve implantation (TAVI) have not been investigated beyond 5-year follow-up.

Aims: We aimed to investigate the association between the early residual mean postprocedural gradient (ERMPG) after TAVI and long-term SVD rates as well as the association of SVD with bioprosthetic valve failure (BVF) and 10-year mortality rates.

Methods: Patients with severe aortic valve stenosis enrolled in the Medtronic One Hospital Clinical Service at 10 Italian centres were included in the study. ERMPG was measured with echo-Doppler at hospital discharge or within 3 months from TAVI.

Results: Between September 2007 and December 2014, 1,291 patients undergoing TAVI with a CoreValve/Evolut valve met the enrolment criteria of the study. After a median follow-up of 59.4 months, there were 46 patients with SVD (cumulative incidence rate 3.6%). A significant stepwise increase in the risk of SVD was apparent across tertiles of ERMPG (p=0.009), and in the multivariable analysis, ERMPG was an independent predictor of SVD (adjusted subdistribution hazard ratio [sHR] 1.05, 95% confidence interval [CI]: 1.01-1.08; p=0.004). Among the 46 patients with SVD, 25 (54.3%) had or developed BVF. SVD was associated with increased 10-year rates of all-cause mortality (adjusted hazard ratio 2.12, 95% CI: 1.49-3.00; p<0.001) and cardiac mortality (adjusted sHR 5.78, 95% CI: 2.63-12.71; p<0.001) compared with no SVD.

Conclusions: Echo-Doppler-derived ERMPG measured within 90 days from TAVI is an independent predictor of SVD. SVD is associated with high rates of BVF, and it is an independent predictor of all-cause mortality and cardiovascular mortality.

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Conflict of interest statement

T. Palmerini has received speaker fees from Abbott, Biotronik, Edwards Lifesciences, and Medtronic; he is also a proctor for Evolut (Medtronic) implantation. F. Saia has received consultancy and lecture fees from Abbott, Edwards Lifesciences, and Medtronic. B. Bellini has received consultant fees from Medtronic. M. Montorfano has received consultant fees from Abbott, Boston Scientific, Kardia Medical, and Medtronic. The other authors have no conflicts of interest to declare.

References

    1. Forrest JK, Deeb GM, Yakubov SJ, Gada H, Mumtaz MA, Ramlawi B, Bajwa T, Teirstein PS, DeFrain M, Muppala M, Rutkin BJ, Chawla A, Jenson B, Chetcuti SJ, Stoler RC, Poulin MF, Khabbaz K, Levack M, Goel K, Tchétché D, Lam KY, Tonino PAL, Ito S, Oh JK, Huang J, Popma JJ, Kleiman N, Reardon MJ Low Risk Trial Investigators. 3-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis. J Am Coll Cardiol. 2023;81:1663–74. - PubMed
    1. Gleason TG, Reardon MJ, Popma JJ, Deeb GM, Yakubov SJ, Lee JS, Kleiman NS, Chetcuti S, Hermiller JB, Heiser J, Merhi W, Zorn GL, Tadros P, Robinson N, Petrossian G, Hughes GC, Harrison JK, Conte JV, Mumtaz M, Oh JK, Huang J, Adams DH CoreValve U. S. Pivotal High Risk Trial Clinical Investigators. 5-Year Outcomes of Self-Expanding Transcatheter Versus Surgical Aortic Valve Replacement in High-Risk Patients. J Am Coll Cardiol. 2018;72:2687–96. - PubMed
    1. Mack MJ, Leon MB, Smith CR, Miller DC, Moses JW, Tuzcu EM, Webb JG, Douglas PS, Anderson WN, Blackstone EH, Kodali SK, Makkar RR, Fontana GP, Kapadia S, Bavaria J, Hahn RT, Thourani VH, Babaliaros V, Pichard A, Herrmann HC, Brown DL, Williams M, Akin J, Davidson MJ, Svensson LG PARTNER 1 trial investigators. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet. 2015;385:2477–84. - PubMed
    1. Mack MJ, Leon MB, Thourani VH, Pibarot P, Hahn RT, Genereux P, Kodali SK, Kapadia SR, Cohen DJ, Pocock SJ, Lu M, White R, Szerlip M, Ternacle J, Malaisrie SC, Herrmann HC, Szeto WY, Russo MJ, Babaliaros V, Smith CR, Blanke P, Webb JG, Makkar R PARTNER 3 Investigators. Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Years. N Engl J Med. 2023;389:1949–60. - PubMed
    1. Martinsson A, Nielsen SJ, Milojevic M, Redfors B, Omerovic E, Tønnessen T, Gudbjartsson T, Dellgren G, Jeppsson A. Life Expectancy After Surgical Aortic Valve Replacement. J Am Coll Cardiol. 2021;78:2147–57. - PubMed

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