Age-stratified baseline and outcome characteristics of patients undergoing transcatheter aortic valve implantation: results from the German multicenter registry
Buellesfeld, L.; Gerckens, U.; Erbel, R.; Zahn, R.; Linke, A.; Sievert, H.; Figulla, H.R.; Kuck, K.-H.; Hauptmann, K.-E.; Hambrecht, R.; Richardt, G.; Naber, C.; Voehringer, M.; Mudra, H.; Senges, J.; Grube, E.; Gerckens, U.; Grube, E.; Buellesfeld, L.; Eggebrecht, H.; Erbel, R.; Zahn, R.; Herzzentrum, U.ät.L.; Linke, A.; Schuler, G.; Sievert, H.; Figulla, H.R.; Kuck, K.H.; Hauptmann, K.E.; Hoffmann, E.; Hambrecht, R.; Nickenig, G.; Richardt, G.; Block, M.; Naber, C.H.; Neumann, F.J.; Sechtem,
Journal of Invasive Cardiology 24(10): 531-536
2012
ISSN/ISBN: 1557-2501 PMID: 23043037 Document Number: 657226
To analyze age dependencies in patients currently undergoing transcatheter aortic valve implantation (TAVI) based on the German TAVI registry. TAVI is a promising, less invasive treatment option for surgical high-risk patients with symptomatic aortic valve stenosis, with the majority being octogenarians treated so far. Younger patients with significant co-morbidities are now increasingly considered for this procedure, but little is known about this population. The German TAVI registry is an ongoing non-randomized national multicenter study. Consecutive patients who underwent TAVI between January 2009 and June 2010 were included in this analysis. We compared baseline characteristics, procedural characteristics, and short-term clinical outcome up to 30-day follow-up. A total of 1386 patients were divided into 4 roughly equally-sized groups: group A, n = 347, mean age 73.4 ± 4.5 years; group B, n = 350, mean age 80.6 ± 1.1 years; group C, n = 382, mean age 84.5 ± 1.1 years; and group D, n = 312, mean age 88.9 ± 2.2 years. Patient characteristics varied significantly, with more co-morbidities in younger patients. Technical success rates were similar in all groups (96.6%-97.7%; P=NS). 30-day major adverse event rates were similar with an all-cause mortality rate of 7.2% (A), 7.1% (B), 9.7% (C) and 8.7% (D; P=NS). Postprocedural improvement of both New York Heart Association and self-reported health status was significant in all groups, with significantly better improvements in the categories 'mobility' and 'ability for self-care' in younger patients. TAVI appears to be similarly safe and effective across different age groups with currently applied enrollment criteria, but younger patients present with significantly more co-morbidities. All patient populations experience functional improvements, but this is particularly pronounced for younger patients.