Valvular & structural heart diseaseCohort study
Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement
- international, multicenter registry
- consecutive patients
- 13 centers
- competing-risk approach
- Bioprosthetic valve failure (BVF) as a time-dependent covariate
Authors' conclusion
BVF is a clinically relevant event associated with adverse long-term outcomes. These findings support the implementation of tailored surveillance and preventive strategies to mitigate BVF-related risk.
Study context
- Population
- Consecutive patients undergoing transcatheter aortic valve replacement
- Participants
- 7,501 patients
- Exposure
- BVF as a time-dependent covariate and clinical outcomes
- BVFn = 380
- Outcome
- BVF according to Valve Academic Research Consortium-3 criteria
- Follow-up
- Median 4 (interquartile range, 2-5) years
Main finding
As reported in the abstract
BVF occurred
380 (5.1%)
Cumulative incidence at 1 year
1.4%
Cumulative incidence at 5 years
4.6%
Cumulative incidence at 10 years
8.3%
Observational data: associations, not effects.
Further findings
Independent predictors of BVF
- younger age, smoking, balloon-expandable valve, prosthesis size <26 mm, valve-in-valve procedure, mean gradient at discharge ≥15 mm Hg, moderate or severe aortic regurgitation at discharge, and early hemodynamic valve deterioration
Clinical outcomes associated with BVF
- All-cause mortality, adjusted hazard ratio
- 1.72 [95% CI, 1.47-2.01]; P <0.001
- Cardiovascular mortality, adjusted hazard ratio
- 3.23 [95% CI, 2.73-3.82]; P <0.001
- Stroke, adjusted hazard ratio
- 2.08 [95% CI, 1.02-4.23]; P =0.043
- Heart failure hospitalization, adjusted hazard ratio
- 1.43 [95% CI, 1.03-1.98]; P =0.032
- increased risk with BVF
- Consistent findings were observed in different sensitivity analyses.
Original publication
Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement. Circ Cardiovasc Interv. Published 24 August 2026. doi:10.1161/circinterventions.126.016892
Summarised from the published abstract; every number is checked against it