Long-Term Valve Durability in Patients Undergoing Transcatheter Aortic Valve Implantation

医学 主动脉瓣 入射(几何) 心脏病学 累积发病率 外科 内科学 人口 队列 环境卫生 光学 物理
作者
Julia Stehli,M. Dagan,S. Duffy,Stéphane Morisset,Pieter A. Vriesendorp,Shane Nanayakkara,Samuel Ji Quan Koh,E. Quine,N. Htun,Dion Stub,Ron Dick,Antony Walton
出处
期刊:Heart Lung and Circulation [Elsevier BV]
卷期号:32 (2): 240-246 被引量:7
标识
DOI:10.1016/j.hlc.2022.10.006
摘要

To evaluate the long-term incidence of structural valve deterioration (SVD) in patients who underwent transcatheter aortic valve implantation (TAVI).Between 2008 and 2018, 693 underwent TAVI at two centres. Four hundred and twenty-one (421) patients (mean age 83.6±6.0 yrs) survived for ≥2 years post TAVI and had at least two consecutive transthoracic echocardiographies (TTEs) with the latest TTE no less than 2 years after TAVI, and were therefore included in the analysis for SVD. Median follow-up was 4.7 (3.6-6.0) years and median echocardiography follow-up 3 (3.0-4.0) years. All-cause mortality was 30.9% (130) with a median time to death of 4.1 (3.0-5.6) years. The cumulative incidence of SVD increased from 1.7% (95% CI, 0.4-2.9) at 3 years to 3.5% (95% CI, 1.5-5.8) at 5 years and 4.7% (95% CI, 1.6-7.9) at 10 years. The overall median time to SVD was 3 (2-4) years. Twelve (12) patients demonstrated SVD stage 2, and 1 patient stage 3. No SVD required re-intervention. All other patients showed no significant changes in valve parameters over time.Structural valve deterioration is an uncommon event, occurring in 5% over a total follow-up of 10 years. Most patients show stable valve parameters. However, the analysis is limited by the loss of follow-up (owing to patient mortality), which renders extrapolation of the data to a younger patient population difficult.
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