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Original article
Long-term outcome after transcatheter aortic valve implantation
  1. Claire Bouleti1,2,
  2. Dominique Himbert1,3,
  3. Bernard Iung1,2,3,
  4. Benjamin Alos1,
  5. Caroline Kerneis1,
  6. Walid Ghodbane1,
  7. David Messika-Zeitoun1,2,3,
  8. Eric Brochet1,
  9. Amir-Ali Fassa1,
  10. Jean-Pol Depoix1,
  11. Phalla Ou4,
  12. Patrick Nataf1,2,
  13. Alec Vahanian1,2,3
  1. 1Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
  2. 2Faculté de Médecine Paris-Diderot University Paris 7, Paris, France
  3. 3INSERM U698 Bichat Hospital, Paris, France
  4. 4Department of Radiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
  1. Correspondence to Dr Claire Bouleti, Department of Cardiology, Bichat Hospital, 46 rue Henri-Huchard, Paris 75018, France; claire.bouleti{at}gmail.com

Abstract

Objective To assess late outcome after transcatheter aortic valve implantation (TAVI) up to 6 years and to analyse its predictive factors with a particular emphasis on functional status. Very few data exist on the long-term results of TAVI, and these data are crucial for decision making.

Methods Between October 2006 and December 2009, 123 consecutive patients were discharged alive after TAVI in our institution. Mean age was 82±8 years, and 88% of patients were highly symptomatic in New York Heart Association (NYHA) class III–IV.

Results Follow-up was complete in 122 patients (99%). The overall 6-year survival rate was 31%±5%, the majority of deaths being non-cardiac. Predictive factors of late mortality were the presence of lower limb arteritis (p=0.009), a higher Charlson comorbidity index (p=0.03) and post-TAVI paraprosthetic aortic regurgitation ≥2/4 (p=0.01). Late outcomes according to Valve Academic Research Consortium-2 criteria were analysed, and the 5-year event-free survival rate was 28%±4%. Finally, the rate of good functional results, defined as survival in NYHA class I or II, was 32%±5% at 5-year follow-up. In the survivors, the EQ-5D questionnaire further confirmed the benefit in terms of quality of life.

Conclusions About one-third of patients discharged alive after TAVI were alive at 6-year follow-up, and the survivors exhibited good functional results assessed by NYHA class and quality-of-life standardised evaluation.

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