Clinical outcomes of transcatheter aortic valve implantation in nonagenarians.

Abstract

BACKGROUND: Surgical Aortic Valve Replacement (SAVR) has been the gold standard for managmement of aortic stenosis until Transcatheter Aortic Valve Implementation (TAVI) emerged. TAVI is an alternative treatment option for intermediate and high risk patients. The aim of this research was to evaluate the clinical outcomes of the ≥90 years patient group compared with the <90 years patient group who have had TAVI at Epworth HealthCare and Alfred Hospital. METHODS: Data were prospectively collected from August 2008 to April 2017 on 559 patients. Data were divided into two groups, ≥90 and <90 year old. Data points included: Society of Thoracic Surgeons (STS) score, clinical frailty score (CFS), 30-day mortality and stroke, and one through to 6 year survival. RESULTS: Of 559 patients, 66 (33%) were nonagenarians. CFS of 3.9 (range 1-9). Average NYHA at discharge 1 (range 1-4). [See table on poster]. CONCLUSIONS: TAVI has become the preferred method of AVR in the elderly population. Our data suggest that TAVI can be undertaken safely in very elderly patients with good survival. Therefore, patients should not be excluded based on age alone. Careful work up in selected patients remains integral to optimal outcomes.