Long-term results and durability of the CoreValve transcatheter aortic bioprosthesis: outcomes beyond five years.

AIMS: to determine long-term outcomes of high-risk patients who underwent transcatheter aortic valve implantation (TAVI) with third-generation CoreValve device, according to the 2017 EAPCI/ESC/EACTS definition of valve durability.

METHODS AND RESULTS: between 2007 and 2013, 278 consecutive patients were enrolled in our prospective single-centre CoreValve registry (mean age 82±6 years, mean STS score 6.4±5.0%); median follow-up of survivors was 6.8 years. The Cox proportional hazards model was used to identify independent predictors of HF-rehospitalization and all-cause mortality. Predictors of HF-rehospitalization were LVEF, MR and PVL at last echocardiographic follow-up. The majority of patients were in NYHA class I or II and showed mild/trivial paravalvular leak throughout follow-up. Mean pressure gradients remained stable over time. The overall crude cumulative incidences of structural valve deterioration and bioprosthetic valve failure were 3.6% and 2.5% respectively.

CONCLUSIONS: although overall mortality was high in this elderly patient cohort, the CoreValve bioprosthesis showed excellent durability at 7-year follow-up.