Life expectancy and early to mid-term dysfunction of transcatheter aortic prostheses: incidence, modes, correlates, and outcome

Abstract Backgrounds Bioprosthetic valve dysfunction (BVD) is a major concern regarding transcatheter aortic implantation (TAVI) in low-risk patients. Aims To assess incidence, determinants, modes, and outcome of early to mid-term BVD after TAVI relation with life expectancy. Methods Consecutive recipients (2007–2020) post-interventional follow-up ≥1-year were prospectively included. components bioprosthetic failure (BVF) assessed according updated Valve-Academic-Research-Consortium-3 criteria. Echocardiographic laboratory was performed prior discharge, at 3- 12-months, yearly thereafter. BVD/BVF all-cause death served as endpoints. Average expectancy calculated from National Open Health Data patients stratified tertiles (1st: <6.85y, 2nd: 6.85–9.7y, 3rd: >9.7y). Results Of 1047 (81.6±6.8 y/o, 52.7% female, EuroSCORE II 4.5±2.5), ≥2 follow-ups available 622 (serial echo cohort). After median 12.2 months, incidence rates BVF 8.4% [95% confidence interval 6.7–10.3], 3.5% [2.5–4.9] per valve-year, respectively, without differences between (Figure 1). double within the first year implant (9.9% [7.7–12.6] valve-year; mostly non-structural VD) vs. beyond (4.8% [3.1–7.2] structural VD). Valve-in-valve procedure, stenosis severity (both p<0.05), but not age/life (p>0.5) predisposed for BVD. 4.4±3.0 years, mortality 36.7%. Time-dependent independently associated (adjusted hazard ratio [AHR] 1.72 [1.06–2.88]/ 2.97 [1.72–6.22]) second (AHR 1.96 [1.02–3.73]/ 2.31 [1.00–5.30]), third tertile 1.42 [0.66–3.12]/ 1.84 [0.71–4.79]; Figure Conclusions In this large prospective observational cohort, occurred same rate across spectrum prognostic among those longest Funding Acknowledgement Type funding sources: None.