Valvular & structural heart disease
Predictors of long-term structural valve deterioration and failure after transcatheter aortic valve implantation
Authors' conclusion
Echo-Doppler-derived ERMPG measured within 90 days from TAVI is an independent predictor of SVD. SVD is associated with high rates of BVF, and it is an independent predictor of all-cause mortality and cardiovascular mortality.
Study context
- Population
- Patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI) with a CoreValve/Evolut valve, September 2007 to December 2014patients undergoing TAVI with a CoreValve/Evolut valve who met the enrolment criteria
- Participants
- 1,291 patients
- Comparison
- Early residual mean postprocedural gradient (ERMPG) as predictor of structural valve deterioration (SVD); SVD compared with no SVD for 10-year mortality
- SVDn = 46
- Outcome
- SVD
- Follow-up
- Median 59.4 months
Main finding
As reported in the abstract
Patients with SVD
46
Cumulative incidence rate
3.6%
Further findings
ERMPG as independent predictor of SVD
| Adjusted sHR (95% CI) | P value | ||
|---|---|---|---|
| ERMPGMultivariable analysis | 1.05 (1.01–1.08) | P = 0.004 | |
| 0.512Adjusted subdistribution hazard ratio (log scale) |
| Outcome | Estimate | P value | |
|---|---|---|---|
| All-cause mortality · 10-year | adjusted hazard ratio 2.12 (95% CI 1.49–3.00) | P < 0.001 | |
| Cardiac mortality · 10-year | adjusted sHR 5.78 (95% CI 2.63–12.71) | P < 0.001 | |
| 0.050.21520Ratio (log scale) |
Risk of SVD across tertiles of ERMPG
- Significant stepwise increase
- P = 0.009
Bioprosthetic valve failure (BVF) among patients with SVD
- Of the 46 patients with SVD, had or developed BVF
- 25 (54.3%)
Original publication
Predictors of long-term structural valve deterioration and failure after transcatheter aortic valve implantation. EuroIntervention. Published 19 January 2026. doi:10.
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