Background: The eligibility of cancer survivors and patients with active cancer disease to transcatheter aortic valve replacement (TAVR) is permanently increasing, signalizing a definitive need to adjust the indication and the risk assessment before intervention.

Objectives: To determine the impact of cancer disease on periprocedural complications and survival in a long-term single center cohort of patients treated with TAVR.

Methods: Patients treated with TAVR between January 2006 and December 2018 were analyzed as control patients (patients without cancer disease), stable cancer (SC) group, and active cancer (AC) group. The primary endpoints were periprocedural complications and 30-day survival. Secondary endpoint was 10-year survival.

Results: 1,088 patients (81±5 years, 46.6% men) treated with transfemoral TAVR were selected: 839 controls, 196 SC, 53 AC. Predominant malignancies were breast, gastrointestinal, and prostate cancer. No differences were seen between cancer patients and controls regarding periprocedural complications. Patients with AC had similar 30-day survival compared to controls and SC, with reduced 10-year survival. AC was associated with more than 40% excess risk of all-cause 10-year mortality, which persisted after multivariable adjustment.

Conclusions: TAVR should be performed in cancer patients when indicated, considering that patients with cancer have similar periprocedural complications and short-term survival compared to control patients, with reduced long-term survival in patients with AC. Further studies should determine which cancer-related parameters impact the prognosis of these patients.