title: Age-stratified baseline and outcome characteristics of patients undergoing transcatheter aortic valve implantation: results from the German multicenter registry.
abstract: OBJECTIVE
  To analyze age dependencies in patients currently undergoing transcatheter aortic valve implantation (TAVI) based on the German TAVI registry.
  
  
  BACKGROUND
  TAVI is a promising, less invasive treatment option for surgical high-risk patients with symptomatic aortic valve stenosis, with the majority being octogenarians treated so far. Younger patients with significant co-morbidities are now increasingly considered for this procedure, but little is known about this population.
  
  
  METHODS
  The German TAVI registry is an ongoing non-randomized national multicenter study. Consecutive patients who underwent TAVI between January 2009 and June 2010 were included in this analysis. We compared baseline characteristics, procedural characteristics, and short-term clinical outcome up to 30-day follow-up.
  
  
  RESULTS
  A total of 1386 patients were divided into 4 roughly equally-sized groups: group A, n = 347, mean age 73.4 ± 4.5 years; group B, n = 350, mean age 80.6 ± 1.1 years; group C, n = 382, mean age 84.5 ± 1.1 years; and group D, n = 312, mean age 88.9 ± 2.2 years. Patient characteristics varied significantly, with more co-morbidities in younger patients. Technical success rates were similar in all groups (96.6%-97.7%; P=NS). 30-day major adverse event rates were similar with an all-cause mortality rate of 7.2% (A), 7.1% (B), 9.7% (C) and 8.7% (D; P=NS). Postprocedural improvement of both New York Heart Association and self-reported health status was significant in all groups, with significantly better improvements in the categories 'mobility' and 'ability for self-care' in younger patients.
  
  
  CONCLUSIONS
  TAVI appears to be similarly safe and effective across different age groups with currently applied enrollment criteria, but younger patients present with significantly more co-morbidities. All patient populations experience functional improvements, but this is particularly pronounced for younger patients.
authors.affiliation: Department of Cardiology, Bern University Hospital, CH-3010 Bern, Switzerland. Lutz.Buellesfeld@insel.ch
authors.forename: Lutz
authors.initials: L
authors.lastname: Buellesfeld
authors.forename: Ulrich
authors.initials: U
authors.lastname: Gerckens
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Ralf
authors.initials: R
authors.lastname: Zahn
authors.forename: Axel
authors.initials: A
authors.lastname: Linke
authors.forename: Horst
authors.initials: H
authors.lastname: Sievert
authors.forename: Hans R
authors.initials: HR
authors.lastname: Figulla
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Karl-Eugen
authors.initials: KE
authors.lastname: Hauptmann
authors.forename: Rainer
authors.initials: R
authors.lastname: Hambrecht
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Christoph
authors.initials: C
authors.lastname: Naber
authors.forename: Matthias
authors.initials: M
authors.lastname: Voehringer
authors.forename: Harald
authors.initials: H
authors.lastname: Mudra
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Eberhard
authors.initials: E
authors.lastname: Grube
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome