Valvular & structural heart diseaseCohort study
Hemodynamic Valve Deterioration After Transcatheter Aortic Valve Replacement
- Prospective registry cohort study
- consecutive patients
- case control-matched
- Median follow-up 376 days (Q1-Q3: 365-1,825 days)
Authors' conclusion
HVD occurred in up to 1 in 4 patients throughout 10-year post-TAVR and was associated with a 5-fold increase in the risk of aortic valve reintervention.
Study context
- Population
- Consecutive patients undergoing transcatheter aortic valve replacement (TAVR) in the Bern TAVI registry, August 2007–June 2022matched cohort 155 vs 600
- Participants
- 2,403 patients
- Exposure
- Hemodynamic valve deterioration (HVD) vs no HVD
- HVDn = 155
- no-HVDn = 600reference
- Outcome
- Cumulative incidence of moderate or severe HVD (VARC-3)
- Follow-up
- 1, 5 and 10 years
Main finding
As reported in the abstract
Cumulative incidence of moderate or severe HVD
1 year
2.2% (95% CI 1.6%-3.1%)
5 years
10.8% (95% CI 9.2%-12.7%)
10 years
25.6% (95% CI 17.5%-36.5%)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Independent predictors of HVD — Aortic valve complex calcium volume vs no-HVD | HR 1.81 (95% CI 1.11–2.97) | P = 0.018 | |
| Independent predictors of HVD — Residual aortic regurgitation at discharge vs no-HVD | HR 1.87 (95% CI 1.34–2.60) | P < 0.001 | |
| Independent predictors of HVD — Treatment with oral anticoagulants vs no-HVD | HR 1.78 (95% CI 1.00–3.15) | P = 0.048 | |
| Clinical outcomes, case control-matched cohort · repeat aortic valve intervention · matched cohort | RR 4.81 (95% CI 1.74–13.26) | P = 0.001 | |
| 0.050.21520Ratio (log scale) |
Clinical outcomes, case control-matched cohort
- Similar yearly rates of all-cause and CV mortality, and infective endocarditis
Original publication
Hemodynamic Valve Deterioration After Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. Published 13 January 2025. doi:10.1016/j.jcin.2024.09.039
Summarised from the published abstract; every number is checked against it