28 Mar 2019
Long-term results and durability of the CoreValve transcatheter aortic bioprosthesis: outcomes beyond five years
EuroIntervention Journal
A study to determine the long-term outcomes of high-risk patients who underwent transcatheter aortic valve implantation with the third-generation CoreValve device, according to the 2017 EAPCI/ESC/EACTS definition of valve durability.
Aims: The aim of this study was to determine the long-term outcomes of high-risk patients who underwent transcatheter aortic valve implantation (TAVI) with the third-generation CoreValve device, according to the 2017 EAPCI/ESC/EACTS definition of valve durability.
Methods and results: Between 2007 and 2013, 278 consecutive patients were enrolled in our prospective single-centre CoreValve registry (mean age 82±6 years, mean STS score 6.4±5.0%). The median follow-up of survivors was 6.8 years. The Cox proportional hazards model was used to identify independent predictors of HF rehospitalisation and all-cause mortality. Predictors of HF rehospitalisation were LVEF, MR and PVL at the last echocardiographic follow-up. The majority of patients were in NYHA Class I or II and showed mild/trivial paravalvular leak throughout follow-up. Mean pressure gradients remained stable over time. The overall crude cumulative incidences of structural valve deterioration and bioprosthetic valve failure were 3.6% and 2.5%, respectively.
Conclusions: Although overall mortality was high in this elderly patient cohort, the CoreValve bioprosthesis showed good durability at seven-year follow-up
Authors
R. Antonazzo Panico, C. Giannini, M. De Carlo, M. Angelillis, P. Spontoni, A. Pieroni, G. Costa, P. Bertini, F. Guarracino, A. Sonia Petronio
