Survival outcomes of elderly patients undergoing transcatheter aortic valve implantation after 3 years of follow-up

BACKGROUND: Severe aortic stenosis is typically treated with transcatheter aortic valve implantation (TAVI) in elderly patients with contraindications for surgery or elderly patients who have a high risk for surgical aortic valve replacement. Currently, there is a paucity of data on the survival outcomes for patients older than 85 years who underwent TAVI. AIM: To determine survival and predictors of mortality in patients older than 85 years who underwent TAVI. METHODS: A retrospective cohort study was conducted on 64 patients ≥ 85 years of age who underwent TAVI between 2010 and 2023 at the King Abdulaziz Cardiac Center in Riyadh, Saudi Arabia. Baseline demographics, echocardiographic parameters, procedural outcomes, and mortality data were collected and analyzed at the 1-year and 3-year follow-up appointments. RESULTS: The mean patient age was 88.3 ± 3.6 years, and 81.3% of the patients were male. The most common comorbidities were hypertension (79.7%), diabetes (60.9%), and coronary artery disease (53.1%). The mean left ventricular ejection fraction was 51.1% with a mean transvalvular gradient of 45.1 mmHg. The 1-year and 3-year survival rates were 82% and 63%, respectively. The mean survival duration was 56.3 months. Multivariate analysis identified body mass index ≥ 30 as significant predictor of early mortality (odds ratio: 3.13, 95% confidence interval: 1.01-4.75). CONCLUSION: Favorable survival outcomes were observed in patients 85 years or older who underwent TAVI. The mortality risk increased in patients with obesity.