Valvular & structural heart diseaseCohort study
Impact of Early Hemodynamic Valve Deterioration on Long-Term Outcomes Following Transcatheter Aortic Valve Replacement
- Prospective registry cohort study
- single-centre
- consecutive patients
- propensity-score matched sensitivity analysis
Authors' conclusion
Early HVD was associated with worse long-term clinical and hemodynamic outcomes after TAVR.
Study context
- Population
- Consecutive patients undergoing transcatheter aortic valve replacement (TAVR), single-centre registry, 2007–2023early hemodynamic valve deterioration (HVD) in 68 (3.6%)
- Participants
- 1,912 patients
- Exposure
- Early HVD vs no early HVD after TAVR
- Early HVDn = 68
- Outcome
- Valve-related long-term clinical efficacy (VARC-3)
- Follow-up
- Median 1,107 days (Q1-Q3: 369-1,697 days)
Main finding
As reported in the abstract
median follow-up 1,107 days
Subdistribution hazard ratio
0.43
95% CI 0.27–0.68
P < 0.001
Early HVD vs No early HVD
sHR 0.43 (95% CI 0.27–0.68); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | sHR (95% CI) | P value | |
|---|---|---|---|
| Stroke · median follow-up 1,107 days | 3.03 (1.59–5.76) | P < 0.001 | |
| Stage 2 or 3 bioprosthetic valve deterioration · median follow-up 1,107 days | 7.40 (4.51–12.6) | P < 0.001 | |
| Stage 3 bioprosthetic valve deterioration · median follow-up 1,107 days | 5.43 (2.44–12.1) | P < 0.001 | |
| Bioprosthetic valve failure · median follow-up 1,107 days | 2.70 (1.30–5.61) | P = 0.007 | |
| 0.050.21520Subdistribution hazard ratio (log scale) |
- Incidence of early HVD · within 3 months after TAVR
- 3.6% · 68 of 68
Independent predictors of early HVD
- Smaller annular area (OR per 10-mm² decrease)
- 1.03; 95% CI: 1.00-1.08
- Valve-in-valve procedure (OR)
- 3.86; 95% CI: 1.95-7.45
- No anticoagulation at discharge (OR)
- 2.44; 95% CI: 1.28-5.26
- P < 0.05 for all
Original publication
Impact of Early Hemodynamic Valve Deterioration on Long-Term Outcomes Following Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. Published 27 October 2025. doi:10.1016/j.jcin.2025.08.020
Summarised from the published abstract; every number is checked against it