Background: Transcatheter aortic valve implantation (TAVI) is the standard of care treatment for elderly patients suffering from severe symptomatic aortic stenosis (AS) irrespective of surgical risk. Thus, real-word TAVI cohorts represent all risk categories and therefore, the prediction of long-term prognosis is still challenging. Since follow-up (FU) appointments in the implanting heart-centre are frequently offered to TAVI patients, the aim of the current analysis was to test the predictive value of perceiving such visits for long-term mortality.

Methods and Results: The current study included 592 patients (mean age: 79 ± 7 years; 51% female; mean STS score 4.7 ± 3.8%) that underwent transfemoral TAVI and agreed to participate in the local aortic valve registry at the University Hospital Jena (Jenaer Aortenklappenregister, JAKR) between 2016 and 2020. For all patients, data on short (30 day) and long-term (1 and 2 years) mortality were available. In a first step, the cohort was dichotomized into survivors (n = 463) and non-survivors (n= 129) after 2 years and risk assessment scores and comorbidities at baseline as well as perception of the 6-week FU were compared between the groups. Parameters showing significant differences (p<0.05) were included as co-variates into logistic regression analysis and the following independent predictors of long-term survival were identified: STS score (OR: 1.103, 95% CI: 1.022 - 1.192, p=0.012); coronary artery disease (OR: 2.597, 95% CI: 1.271 - 5.304, p=0.012); glomerular filtration rate (OR: 0.983, 95% CI: 0.969 - 0.997, p=0.017); clinical frailty scale (OR: 1.507, 95% CI: 1.166 - 1.948, p=0.002) and perceiving 6-week FU (OR: 0.396, 95% CI: 0.219 - 0.717, p=0.002). Kaplan-Meier survival analysis revealed a significantly increased survival rate (84.4%) for patients that perceived FU compared to those who did not (66.2%, p<0.001, figure 1).

Conclusion: Compared to established risk prediction scores, e.g., the STS score, and classical comorbidities at baseline, we could identify for the first time that perceiving the 6-week FU at the implanting heart-centre is an independent predictor of 2-year mortality after TAVI in a real-world setting. Thus, we encourage implementing standardized FU protocols for patients that underwent TAVI with an outpatient FU visit at least once within the first weeks after the procedure.