https://doi.org/10.1007/s00392-025-02625-4
1Universitätsklinikum Hamburg-Eppendorf Klinik für Kardiologie Hamburg, Deutschland; 2Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Hamburg, Deutschland; 3Universitäres Herz- und Gefäßzentrum Hamburg Allgemeine und Interventionelle Kardiologie Hamburg, Deutschland; 4Universitätsklinikum Hamburg-Eppendorf Herz- und Gefäßchirurgie Hamburg, Deutschland; 5Universitäres Herz- und Gefäßzentrum Hamburg Klinik und Poliklinik für Herz- und Gefäßchirurgie Hamburg, Deutschland; 6Universitäres Herz- und Gefäßzentrum Hamburg Klinik und Poliklinik für Kardiologie Hamburg, Deutschland
Background
Transcatheter aortic valve implantation (TAVI) has revolutionised the treatment of aortic stenosis, particularly for patients at high surgical risk. While early results are promising, long-term patient survival, durability and functionality of the prosthetic valves remain critical concerns. This project examines the 10-year follow-up data after TAVI, focusing on the baseline characteristics of 10-year survivors vs. non-survivors.
Methods
All patients of the HARbOR study group (single centre TAVI registry) who underwent TAVI implantation before May 2015 were included. The primary endpoint (death) was analysed using the death registry and survivors were contacted by telephone call for follow up. Statistical analyses were performed using the Kruskal Wallis test for continuous variables expressed as median (1st, 3rd quartile) and the Chi Square test for binary variables expressed in percent. Data are presented as survivors vs. non-survivors.
Results
1505 patients underwent TAVI before May 2015. Of these 1505 patients, 169 were lost to follow-up (unknown status/date of death, withdrawal of consent). 1239 non-survivors and 97 survivors (10-year survival of 6,4%) were included in the final analysis. Baseline characteristics showed significant differences, with survivors being younger age at the time of the procedure (79,7 (74, 83) vs. 82 (77, 86) years), less severely symptomatic (NYHA IV: 3,1 vs. 16,4%), lower calculated risk scores (STS and Euro-Score II), better renal function (GFR, 60 (59,61) vs. 50 (36, 60) ml/min), better LVEF (76 vs. 63%), less low-gradient aortic stenosis, less tricuspid regurgitation (≥II+, 13,9 vs 30%) and less mitral regurgitation (≥II+, 26 vs 41%). However, relevant cardiovascular diseases such as diabetes, coronary artery disease, stroke prosthetic valve type (self vs. balloon expandable) did not differ.
Conclusion and outlook
This study identifies demographic, clinical and echocardiographic variables associated with 10-year survival after TAVI. Further assessment of prosthetic valve function and clinical outcomes other than mortality in 10-year survivors is needed to assess the long-term benefit of TAVI.