Three-Year Outcomes After Transcatheter Aortic Valve Implantation With the CoreValve Prosthesis

• Published in: The American journal of cardiology Vol. 114; no. 4; pp. 606 - 611
• Main Authors: Gotzmann, Michael, MD, Czauderna, Anna, Hehnen, Tobias, MD, Aweimer, Assem, MD, Lind, Alexander, MD, Kloppe, Axel, MD, Bösche, Leif, MD, Mügge, Andreas, MD, Ewers, Aydan, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.08.2014; Elsevier Limited
• Subjects: Aged; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - surgery; Cardiology; Cardiovascular; Coronary vessels; Echocardiography; Female; Follow-Up Studies; Germany - epidemiology; Heart attacks; Humans; Male; Mortality; Prospective Studies; Prosthesis Design; Severity of Illness Index; Survival Rate - trends; Time Factors; Transcatheter Aortic Valve Replacement - methods; Treatment Outcome; Minnesota
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2014.05.043

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.