Valvular & structural heart disease
Incidence, causes, correlates, and outcome of bioprosthetic valve dysfunction and failure following transcatheter aortic valve implantation
Authors' conclusion
In this large prospective observational cohort, early to mid-term BVD after TAVI occurred at the same rate across the spectrum of life expectancy and was associated with increased mortality in patients with short but not in those with the longest life expectancy.
Study context
- Population
- Consecutive transcatheter aortic valve implantation (TAVI) recipients (2007–20) with follow-up ≥1 year622 serial echo cohort
- Participants
- 1,047 recipients
- Exposure
- Life expectancy tertiles
- Outcome
- BVD/BVF (VARC-3) and all-cause death
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Incidence of BVD/BVF · median echo follow-up 12.2 months
Bioprosthetic valve dysfunction (BVD) incidence per valve-year
8.4%
95% CI 6.7–10.3
BVF incidence per valve-year (2.5-4.9)
3.5%
Observational data: associations, not effects.
Further findings
Association of BVD/BVF with outcome, by life expectancy tertile
| Adjusted HR (CI) | ||
|---|---|---|
| 1st tertileBVD | 1.72 (1.06–2.88) | |
| 1st tertileBVF | 2.97 (1.72–6.22) | |
| 2nd tertileBVD | 1.96 (1.02–3.73) | |
| 2nd tertileBVF | 2.31 (1.00–5.30) | |
| 0.10.31310Adjusted hazard ratio (log scale) |
| Outcome | P value |
|---|---|
| Association of BVD/BVF with outcome, by life expectancy tertile3rd tertile · not associated | P = n.s. |
BVD incidence by time since implant
- Within first year, per valve-year
- 9.9%
- Beyond first year, per valve-year
- 4.8%
Correlates of BVD
- Valve-in-valve procedure and residual stenosis, but not age/life expectancy, predisposed for BVD
Original publication
Incidence, causes, correlates, and outcome of bioprosthetic valve dysfunction and failure following transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging. Published 13 September 2022. doi:10.
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