Isaac Pascual, Antonio J Munoz-Garcia, Diego Lopez-Otero, Pablo Avanzas, Manuel F Jimenez-Navarro, Belen Cid-Alvarez, Raquel del Valle, Juan H Alonso-Briales, Raimundo Ocaranza-Sanchez, Jose M Hernandez, Ramiro Trillo-Nouche, Cesar Moris. Transcatheter aortic valve implantation in very elderly patients: immediate results and medium term follow-up[J]. Journal of Geriatric Cardiology, 2015, 12(4): 340-345. DOI: 10.11909/j.issn.1671-5411.2015.04.005
Citation: Isaac Pascual, Antonio J Munoz-Garcia, Diego Lopez-Otero, Pablo Avanzas, Manuel F Jimenez-Navarro, Belen Cid-Alvarez, Raquel del Valle, Juan H Alonso-Briales, Raimundo Ocaranza-Sanchez, Jose M Hernandez, Ramiro Trillo-Nouche, Cesar Moris. Transcatheter aortic valve implantation in very elderly patients: immediate results and medium term follow-up[J]. Journal of Geriatric Cardiology, 2015, 12(4): 340-345. DOI: 10.11909/j.issn.1671-5411.2015.04.005

Transcatheter aortic valve implantation in very elderly patients: immediate results and medium term follow-up

  • Objective To evaluate immediate transcatheter aortic valve implantation (TAVI) results and medium-term follow-up in very elderly patients with severe and symptomatic aortic stenosis (AS). Methods This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly (> 85 years) patients with severe AS treated by with TAVI. The primary endpoint was to evaluate death rates from any cause at two years. Results The study included 160 consecutive patients with a mean age of 87 ± 2.1 years (range from 85 to 94 years) and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 (35.6%) patients scoring ≥ 20%. Procedural success rate was 97.5%, with 25 (15.6%) patients experiencing acute complications with major bleeding (the most frequent). Global mortality rate during hospitalization was 8.8% (n = 14) and 30-day mortality rate was 10% (n = 16). Median follow up period was 252.24 ± 232.17 days. During the follow-up period, 28 (17.5%) patients died (17 of them due to cardiac causes). The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique variable associated with overall mortality. Conclusions TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients.
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