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OBJECTIVE:
Large registries have shown that transcatheter aortic valve implantation (TAVI) can be performed in selected high-risk populations with a high procedural success rate of more than 90% and a 30-day mortality rate ≤10% with varying rate of complications. Little is known about one year mortality after TAVI. The aim of this study was to establish the incidence, predictive factors and actual causes of one year mortality following TAVI.
METHODS:
Between January 2008 and January 2011, a total of 82 patients with symptomatic severe aortic stenosis underwent TAVI with either the Medtronic CoreValve or the Edwards SAPIEN. The route of access was transfemoral in 66 patients (80%), transapical in 9 patients (11%), subclavian in 4 patients (5%), transaortic in 2 patients (3%) and axillary in 1 patient (1%). Baseline characteristics and procedural complications were recorded. Causes of deaths were collected via the bereavement office, GP surgeries and the coroner’s office.
RESULTS:
One month and one year mortality was 4.8% and 15.8%, respectively. Postoperatively, 16 patients (19.5%) required permanent pacemaker implantation. Para-valvular aortic regurgitation was mild or moderate in 38 patients (46.3%). Pre-operative irregular heart rhythm (OR 3.78) and post-operative para-valvular aortic regurgitation (OR 3.45) were independent factors for one year mortality after TAVI. At one year, the most frequent causes of death were bronchopneumonia, cardiac failure and acute myocardial infarction.
CONCLUSIONS:
One year mortality following TAVI was 15.8%. Pre-operative irregular heart rhythm and post procedural para-valvular aortic regurgitation were independent predictive factors. The main causes of death were bronchopneumonia and cardiac disease.