title: Clinical results of transcatheter aortic valve implantation in octogenarians and nonagenarians: insights from the FRANCE-2 registry.
abstract: BACKGROUND
  Although transcatheter aortic valve implantation has been developing as an alternative treatment in elderly patients with high surgical risk, age-specific differences in clinical outcome have not been fully validated.
  
  
  METHODS
  Data were analyzed for 2,254 patients at least 80 years old who were enrolled between January 2010 and October 2011 in the French national transcatheter aortic valve implantation registry, FRANCE-2. Procedural and clinical outcomes defined according to the Valve Academic Research Consortium criteria were compared among subjects in three age groups: 80 to 84 years (n = 867), 85 to 89 years (n = 1,064), and at least 90 years (n = 349; range, 90 to 101 years).
  
  
  RESULTS
  The self-expandable prosthesis was implanted in 710 patients, and the balloon-expandable prosthesis was implanted in 1,544 patients. No differences were observed in rates of procedural success, Valve Academic Research Consortium-defined complications, and length of hospitalization among groups. Cumulative 30-day mortalities did not change among the three groups (80 to 84 years, 10.3% versus 85 to 89 years, 9.5% versus ≥ 90 years, 11.2%; p = 0.53). Cumulative 1-year mortalities also showed no statistical differences, although the mortality rate was higher in patients 85 to 89 years old and at least 90 years old compared with those 80 to 84 years old (19.8% versus 26.1% versus 27.7%; p = 0.16). After adjustment for differential baseline characteristics and potential confounders, patient age (85 to 89 years and ≥ 90 years compared with 80 to 84 years) was not associated with increasing risk of 30-day mortality (hazard ratio, 0.92, 1.26; 95% confidence interval, 0.66 to 1.27, 0.83 to 1.94; p = 0.38, 0.28, respectively) and 1-year mortality (hazard ratio, 1.16, 1.36; 95% confidence interval, 0.90 to 1.49, 0.97 to 1.89; p = 0.25, 0.073, respectively).
  
  
  CONCLUSIONS
  This study revealed acceptable clinical results of transcatheter aortic valve implantation even in very elderly populations.
authors.affiliation: Centre Hospitalier Universitaire (CHU)-Henri Mondor, Creteil, France. Electronic address: masa-nori@nms.ac.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Centre Hospitalier Universitaire (CHU)-Henri Mondor, Creteil, France.
authors.forename: Gauthier
authors.initials: G
authors.lastname: Mouillet
authors.affiliation: Centre Hospitalier Universitaire (CHU)-Henri Mondor, Creteil, France.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Meguro
authors.affiliation: CHU-Brest, Brest, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Gilard
authors.affiliation: CHU-Dupuytren, Limoges, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Laskar
authors.affiliation: Hopital Charles Nicolle, University of Rouen, INSERM Unite 1096, Rouen, France.
authors.forename: Helene
authors.initials: H
authors.lastname: Eltchaninoff
authors.affiliation: Clinique Pasteur, Toulouse, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Fajadet
authors.affiliation: Bichat Hospital, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Iung
authors.affiliation: Insitut Jacques Cartier, Massy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Donzeau-Gouge
authors.affiliation: Pitie-Salpetriere Hospital, Paris, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Leprince
authors.affiliation: CHU-Rennes, Rennes, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Leuguerrier
authors.affiliation: CHU-Lille, Lille, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Prat
authors.affiliation: University Lyon 1, Lyon, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Lievre
authors.affiliation: Centre Hospitalier Universitaire (CHU)-Henri Mondor, Creteil, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Chevreul
authors.affiliation: Centre Hospitalier Universitaire (CHU)-Henri Mondor, Creteil, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Dubois-Rande
authors.affiliation: Centre Hospitalier Universitaire (CHU)-Henri Mondor, Creteil, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Teiger
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D006328:Cardiac Catheterization / Q000379:methods*; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D015577:Geriatric Assessment; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
keywords: 35