Objectives: To analyze age dependencies in patients currently undergoing transcatheter aortic valve implantation (TAVI) based on the German TAVI registry.
Background: TAVI is a promising, less invasive treatment option for surgical high-risk patients with symptomatic aortic valve stenosis, with the majority being octogenarians treated so far. Younger patients with significant co-morbidities are now increasingly considered for this procedure, but little is known about this population.
Methods: The German TAVI registry is an ongoing non-randomized national multicenter study. Consecutive patients who underwent TAVI between January 2009 and June 2010 were included in this analysis. We compared baseline characteristics, procedural characteristics, and short-term clinical outcome up to 30-day follow-up.
Results: A total of 1386 patients were divided into 4 roughly equally-sized groups: group A, n = 347, mean age 73.4 ± 4.5 years; group B, n = 350, mean age 80.6 ± 1.1 years; group C, n = 382, mean age 84.5 ± 1.1 years; and group D, n = 312, mean age 88.9 ± 2.2 years. Patient characteristics varied significantly, with more co-morbidities in younger patients. Technical success rates were similar in all groups (96.6%-97.7%; P=NS). 30-day major adverse event rates were similar with an all-cause mortality rate of 7.2% (A), 7.1% (B), 9.7% (C) and 8.7% (D; P=NS). Postprocedural improvement of both New York Heart Association and self-reported health status was significant in all groups, with significantly better improvements in the categories 'mobility' and 'ability for self-care' in younger patients.
Conclusion: TAVI appears to be similarly safe and effective across different age groups with currently applied enrollment criteria, but younger patients present with significantly more co-morbidities. All patient populations experience functional improvements, but this is particularly pronounced for younger patients.