Comparison of Outcome of Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis in 3 Age Groups (≤70; 71 to 80, and ≥81 Years)

Transcatheter aortic valve implantation (TAVI) has been widely used for the treatment of aortic stenosis. Most pivotal studies of TAVI included patients with a mean age of over 80 years old. Many young patients may also be considered for TAVI because of severe co-morbidities. We sought to describe a group of patients undergoing TAVI at an age below 70 and to compare them with older patients undergoing the procedure. This study included 1,324 consecutive patients from a 3-center TAVI registry from 2008 to 2014. Patients were divided according to age into 3 groups: patients aged 70 years and below, patients between the ages of 71 and 80, and patients 81 years and older. Patients in the younger group had higher body mass index (p <0.001), higher proportion of previous stroke (p = 0.05), peripheral vascular disease (p = 0.03), and diabetes mellitus (p <0.001). Thirty percent of patients in the younger group had functional class IV. Corticosteroids treatment was 5-fold higher in the younger group (p <0.001). Average valve area was lower in the older group (p = 0.004). Thirty-day mortality was similar between the 3 groups. We found no difference in the rate of in-hospital complications. One-year all-cause mortality rate of patients aged 70 years, 71 to 80 years, and >80 years was 7.6%, 7.5%, and 12.6%, respectively, p = 0.01. In conclusion, younger patients undergoing TAVI exhibited higher prevalence of risk factors and co-morbidities that probably explain the decision to perform TAVI rather than surgical aortic valve replacement. Nevertheless, the 1-year mortality of these patients was significantly lower than in older patients.