Transcatheter Aortic Bioprosthesis Durability: A Single-Center Experience

Background: Transcatheter aortic valve implant (TAVI) is gaining momentum in the treatment of severe, symp-tomatic aortic valve stenosis, and its indication is expanding to lower surgical risk individuals, who are generally younger and have a long life expectancy. Therefore, transcatheter bioprostheses durability appears of critical im-portance. Aim of the present study is to evaluate mid-term outcomes of TAVI in a high-volume single center co-hort.Methods: We analyzed all consecutive patients (n = 408) who underwent transfemoral TAVI at a single, high -volume center, between 2007 and 2014. Study objectives were all-cause death and bioprosthetic valve failure (BVF) at long term follow-up. Structural valve deterioration (SVD), BVF and valve-related death were defined ac-cording to current international standards. Follow-up was performed by in person visit and transthoracic echo-cardiography, which was obtained only in a minority of patients, or phone call as per patient preference.Results: At a median follow-up of 1821 days, overall mortality was 64.5%, with cardiovascular disease accounting for roughly half of total deaths. Valve-related deaths occurred in 10 patients. Seventeen patients were diagnosed with BVF, and 15 required repeat intervention. Moderate and severe SVD were observed in 10 and 7 patients, re-spectively. In the subgroup of patients with echocardiographic mid-term follow-up (n = 76), no significant in-crease of transprosthetic gradients nor increase of significant regurgitation was detected.Conclusion: In the present unselected, all-comers cohort, TAVI bioprostheses appeared to have excellent durabil-ity at long-term follow-up.(c) 2022 Elsevier Inc. All rights reserved.