Clinical outcome and quality of life in octogenarians following transcatheter aortic valve implantation (TAVI) for symptomatic aortic stenosis

Abstract Objective TAVI is the alternative option in pts with AS deemed ineligible for surgery. Although mortality and morbidity are measures to assess the effectiveness of treatments, quality of life (QOL) should be an additional target. We assessed clinical outcome and QOL in octogenarians following TAVI. Design All octogenarians with a risk profile considered by the Heart Team to be unacceptable for surgery entered in this registry. QOL was assessed by questionnaires concerning physical and psychic performance. Patients A hundred forty-five octogenarians (age: 84.7±3.4years; male: 48.3%) underwent TAVI for AS (97.2%) or isolated AR (2.8%). NYHA class: 2.8±0.6; Logistic EuroScore: 26.1±16.7; STS score: 9.2±7.7.Echocardiographic assessments included AVA (0.77±0.21cm2), mean/peak gradients (54.5±12.2/88±19.5mmHg), LVEF (21%=EF≤40%), sPAP (43.1±11.6mmHg). Interventions All pts underwent successful TAVI using Edward-SAPIEN valve (71.2%) or Medtronic CoreValve (28.8%). Main outcome measures Rates of mortality at 30days, 6months and 1year were 2.8%, 11.2% and 17.5%. Results At 16-month follow up, 85.5% survived showing improved NYHA class (2.8±0.6 vs 1.5±0.7; p Conclusion TAVI procedures improve clinical outcome and subjective health-related QOL in very elderly patients with symptomatic AS.