title: Three-year outcomes after transcatheter aortic valve implantation with the CoreValve prosthesis.
abstract: There is little known about the long-term results of the CoreValve prosthesis. The aim of this study was to assess the 3-year clinical and hemodynamic outcomes of the CoreValve prosthesis. One hundred fifty consecutive patients with severe aortic stenosis successfully underwent transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis. The primary study end point was death from any cause after TAVI. The secondary end points were defined as (1) cardiovascular death and (2) prosthesis-related mortality and morbidity. At 1 to 3 years, all-cause mortality rates were 25%, 32%, and 41%, respectively, and cardiovascular mortality rates were 14%, 21%, and 27%, respectively. Before TAVI, 95% of patients were in New York Heart Association class III or IV. Of the surviving patients, rates of New York Heart Association class III or IV at 1 to 3 years were 33%, 39%, and 38%, respectively. There was an annual decrease of the valve area of approximately 0.1 cm². Aortic restenosis occurred in 2 patients. Moderate or severe aortic regurgitation (AR) occurred in 15% of patients immediately after TAVI. Twenty patients (13%) had a slight worsening of AR within 3 years. New severe AR did not occur. The incidence of prosthesis-related endocarditis was 0.66% per year. Overall, 7 patients (incidence of 1.5% per year) had a clinically relevant problem of the prosthesis. In conclusion, TAVI with the CoreValve prosthesis had favorable effects on symptoms and outcomes even after 3 years. These results are clouded by side effects, such as AR and prosthesis-related mortality and morbidity.
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany. Electronic address: michael_gotzmann@web.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Gotzmann
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Czauderna
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Hehnen
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Assem
authors.initials: A
authors.lastname: Aweimer
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lind
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Kloppe
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Leif
authors.initials: L
authors.lastname: Bösche
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mügge
authors.affiliation: BG-Kliniken Bergmannsheil, Department of Cardiology and Angiology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Aydan
authors.initials: A
authors.lastname: Ewers
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome