Background:

The current trends towards expansion of transcatheter aortic valve replacement (TAVR) to low risk and younger patients increased the relevance of long-term performance and durability of transcatheter heart valves (THV).

Objective:

To assess the 10-years cumulative rate of structural valve dysfunction (SVD) and hemodynamic performance of Core-valve system, and to evaluate the clinical outcomes.

Methods:

A single Centre analysis derived from a large prospective TAVR-registry. The current analysis included patients who underwent TAVR with Core-Valve system at Heart Centre, Bad Segeberg, Germany between 2007 and 2015.

Results:

302 patients underwent TAVR with Core-valve between 2007-2015, the mean age of patients was 80.22 ± 7.02 year-old, mean aortic valve area (AVA) by transthoracic echocardiography was 0.68 ± 0.23 cm². Cumulative rate of all-cause mortality at 5, 7 and 10 years was (40%, 65.8% and 89.8%) respectively. Of the total cohort, 10 patients had SVD (according to a pre-specified definition) with cumulative incidence rate at 5, 7 and 10 years 1.7%, 4.7% and 10.0%, respectively. AVA was (1.94, 1.87, 1.69 and 1.98 cm²; p= 0.236) at baseline, 5, 7 and 10 years, respectively. Among survivors at 10 years (n=14), 10% had aortic regurgitation (AR) > II and mean/peak pressure gradient of 10.1/17.6 mmHg. 

Conclusion:

Using early generation self-expanding THVs (Core-Valve System), we found a relatively low rate of structural valve deterioration at 10-years follow-up. The current study also described a nearly stationary valve performance during the follow-up period.