PARTNER 1 in +90 Year Old Patients: TAVI and the Age Paradox

A new analyzis of the PARTNER 1 trial showed that patients over 90 undergoing transcatheter aortic valve replacement (TAVI) show no increase in mortality or major cardiovascular events rates, compared to younger patients.

In fact, patients over 90 undergoing TAVI have the same life expectation of someone the same age with no aortic stenosis.

In-hospital outcomes were similar to those of younger patients, though the 90 year olds often required a longer hospital stay.

Mortality at 30 days and stroke also resulted equivalent between 90 year olds and younger patients, major bleeding being the only disadvantage for the eldest patients (+90 years 11%, 80-90 years 9.8% and -80 years 6.9%; p=0.04), though this difference disappeared when adjusting by baseline characteristics. Echocardiography end points did not favor patients over 90, since they showed a higher prevalence of paravalvular leak, both at discharge and at one year.