TAVI at 10 Years: First Study to Assess TAVI Long Term Durability

Original Title: First look at long-term durability of transcatheter heart valves: Assessment of valve function up to 10 years after implantation.
Presenter: Danny Dvir.

Transcatheter aortic valve implantation (TAVI) is being used in increasingly younger patients at low surgical risk, which is why longer survival is expected. The durability of transcatheter aortic prostheses has been assessed only at short or medium term.

The goal of this study was to assess long term valve deterioration risk. The study included patients implanted ≥5 years prior to the study (range 5 to 14 years) in 2 centers in Canada, all receiving the balloon expandable valves Cribier Edwards, Edwards SAPIENS, SAPIENS XT.

 
Valve degeneration was defined as aortic regurgitation, at least moderate, and/or a post procedural >20mmHg mean gradient apparent after the first 30 days, not associated to infectious endocarditis.

 
In all, the study assessed 378 with a mean survival rate of 51 months, and 2 patients to survive 10 years after procedure.
35 patients matched the valve degeneration criteria (23 regurgitation and 12 stenosis). Degeneration mean time was 61 months.

Conclusion
This is the first analysis at such long term after TAVI; it showed significant valve degeneration between years 5 and 7 (at 8 years almost 50% present valve degeneration) and this is often associated to kidney failure.