135: Four-year durability of aortic valve bioprosthesis after transcatheter implantation: an echocardiographic prospective study

Background Transcatheter aortic valve implantation (TAVI) has become a recognized alternative to conventional surgery in high-risk patients with severe symptomatic aortic stenosis. However, little is known about the long-term durability of the prosthesis as assessed by periodic transthoracic echocardiography (TTE). We aim to evaluate aortic valve hemodynamics by TTE performed after TAVI using Edwards Sapien/Sapien XT bioprosthesis. Methods All consecutive patients implanted between March 2005 and January 2012 were included in a prospective registry. TTE data were collected before TAVI, within 7 days, at 6 months and yearly after the procedure. Doppler interrogation was used for peak, mean pressure gradient and effective orifice area (EOA) using the continuity equation. Aortic regurgitation (AR) and ejection fraction (EF) were assessed. Results Two hundred and sixty one patients underwent successful TAVI implantation and were included in the registry (table). Left ventricular ejection fraction (LVEF) was improved early after TAVI procedure. Both Peak and mean pressure gradient significantly decreased after TAVI while EOA increased. No aortic regurgitation >grade 2 was found 3 and 4 years after TAVI. Four-year TTE follow-up did not demonstrate any significant change in peak pressure gradient, mean pressure gradient, EOA or occurrence of severe aortic regurgitation compared to 7-day post-operative. All parameters except LVEF remained significantly improved at 4-year compared to pre-TAVI examination. Conclusion Our study demonstrates the excellent hemodynamic performance of the Edwards Sapien/Sapien XT aortic bioprosthesis 4-year after transcatheter implantation offering promising information on valve durability. Table – TTE parameters. Nb of patients EF (%) EDV (ml) Peak pressure grandient (mmHg) Mean pressure gradient (mmHg) EOA (cm 2 ) AR > grade 2 (nb of patients) Before TAVI 261 55±16 106±40 70±26 46±25 0.66±0.15 9 7 days 261 60±13 * 101±43 19±7 * 10±4 * 1.78±0.24 * 12 * 6 months 140 61±11 * 99±54 18±6 * 10±3 * 1.77±0.26 * 4 * 1 year 122 60±12 * 103±44 18±7 * 10±4 * 1.77±0.29 * 1 * 2 years 56 61±11 * 101±51 19±8 * 10±5 * 1.68±0.25 * μ 1 * 3 years 25 62±8 * 106±25 18±5 * 10±3 * 1.79±0.30 * 0 4 years 9 55±16 123±50 18±5 * 10±3 * 1.75±0.20 * 0 EDV: end diastolic volume. * p