P5982Transcatheter aortic valve replacement in elderly patients with severe symptomatic aortic stenosis

Abstract

Abstract Introduction TAVR has proven to be a safe technique for high-risk patients. The objective of our work is to know the results of TAVR in patients older than 90 years; which are the riskiest and had more complications during the admission. Methods Observational retrospective analysis based on all a single-center registry of all consecutive TAVR (N=518) during the last 10 years (2008–2018). Patients older than 90 years old represent 5.8 of the procedures (N=30). We performed a descriptive analysis of the baseline characteristics of our patient cohort, and the development of events during follow-up. Results Our population, as reflected in TABLE 1, had a median age of 91,32 years old, and the majority were women (57.58%). The procedures were mostly elective, unless in 4 patients (12.12%) that were urgent. None valvuloplasty was done before TAVR in this cohort, neither Valve-in-valve. Stratification scores had a wide range, from 1.45 to 28.8% for EurSCORE II and from 4.19 to 17.19% for STS, with a median of 5.53 and 8.49% respectively. Mortality in the first 30 days and in the first year was 0.00%. Mortality after the first year was 71.40% due to non-cardiovascular events (median time of follow-up of 34.34 months). Finally, we would also like to remark that the incidence of heart failure during the first year was 14.29%, taking into account all the follow-up, the incidence was 37.04%. Despite these data, in our registry, the need for pacemaker after the valve implantation was higher than in younger populations (40.62%), probably due to the age-related fibrosis of the cardiac conduction system. Conclusions TAVR is a very safe procedure with very successful results in elderly patients, nevertheless, due to the frailty of this population, individualization is mandatory in order to optimize the resources. Acknowledgement/Funding None