Four-year durability of clinical and haemodynamic outcomes of transcatheter aortic valve implantation with the self-expanding CoreValve.
OBJECTIVE
Long-term data on the durability of currently available transcatheter heart valves are limited. We sought to assess four-year clinical and echocardiographic outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis.


RESULTS
Between June 2007 and February 2014, 450 consecutive patients with symptomatic severe aortic stenosis underwent TAVI in our institution. For the purposes of this study, we included only those patients undergoing successful TAVI with the CoreValve prosthesis who had a minimum follow-up of four years (n=125). Survival rates at one, two, three and four years were 83.2, 76.8, 73.6 and 66.3%, respectively. Aortic regurgitation was a common finding after the procedure, especially due to paravalvular regurgitation (PVR), which was observed in the majority of patients (71.5%), mostly mild (52.0%). Progression from mild acute PVR to moderate PVR at four-year follow-up was reported in three patients. No cases of severe PVR were observed. Prosthetic valve failure was reported in four patients (3.2%).


CONCLUSIONS
Our study demonstrates that favourable outcomes after successful TAVI are associated with sustained clinical and functional cardiovascular beneﬁts up to four-year follow-up. Signs of moderate prosthetic valve failure are present only in a small percentage of patients.
Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
Simona
S
Gulino
Marco
M
Barbanti
Wanda
W
Deste
Sebastiano
S
Immè
Patrizia
P
Aruta
Vera
V
Bottari
Emanuele
E
Benvenuto
Claudia
C
Tamburino
Alessio
A
Di Landro
Daria
D
Liberto
Letizia
L
Santonoceto
Rita
R
Sicuso
Daniele
D
Di Stefano
Denise
D
Todaro
Emanuela
E
Di Simone
Antonino
A
Indelicato
Daniela
D
Giannazzo
Carmelo
C
Sgroi
Corrado
C
Tamburino
D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012720:Severity of Illness Index; D015996:Survival Rate; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome