Abstract 15006: Comparative Clinical Outcomes among Octogenarians and Nonagenarians after Transcatheter Aortic Valve Implantation: Insights from the FRANCE 2 Registry
Background: Transcatheter aortic valve implantation (TAVI) has been developing as an alternative treatment in elderly patients with high surgical risk. Although advanced age is associated with increased risk of operative-mortality after cardiac surgery, age-specific differences in clinical outcome have not been fully validated in patients underwent TAVI.
Methods and Results: Data were analyzed for 2254 patients aged ≥80 years enrolled French national TAVI registry, FRANCE 2. Procedural and clinical outcomes defined to the Valve Academic Research Consortium (VARC) criteria were compared among subjects in three age groups: 80-84years (n=867), 85-89years (n=1064), and ≥90years (n=349, age-range: 90-101). No differences were observed in rates of procedural success, VARC-defined complications and length of hospitalization between groups. Cumulative 30-day mortalities were 10.3%, 9.5%, and 11.2%, respectively, in each group. Hazard ratio (HR) of 30-day mortality did not significantly change among the 3 groups (80-84years vs. 85-89years; HR: 0.92, p=0.56, 80-84years vs. ≥90 years; HR: 1.14, p=0.52, 85-89years vs. ≥90years; HR: 1.14, p=0.52, respectively). Approach site, type of valve, gender, and estimated preoperative surgical risk score did not influence the results. One-year mortality was higher in patients aged 85-89years and ≥90years compared with those aged 80-84years (19.8% vs. 26.1% vs. 27.7%). In the multivariate models, patient age (cut-off: ≥85years) was an independent predictor of late mortality between 30-day and 1-year (HR: 1.81, p=0.001), whereas it was not a significant factor of 1-year mortality.
Conclusions: This study revealed acceptable clinical results of TAVI even in very elderly populations.
- © 2012 by American Heart Association, Inc.