Objective

Transcatheter Aortic Valve Implantation (TAVI) has now become an established procedure for severe symptomatic aortic stenosis (AS) in patients unsuitable for an aortic valve replacement. Within this cohort of patients left ventricular (LV) function is variable and may influence long-term outcome. The impact of TAVI on LV function at mid to long-term follow-up (FU) is yet unclear. We aim to evaluate the change in LV function and associated survival post TAVI for AS.

Methods

Case notes for all consecutive TAVIs from April 2008 – March 2015 were assessed retrospectively. Patients were routinely followed up in the outpatients clinic and Transthoracic echocardiography (TTE) performed. All patients that had LV function quantified pre and post TAVI were included in this analysis. LV function was classified into 3 categories; poor (EF<30), moderate (EF 30-50), good (EF>50). Statistical analysis was performed for a paired sample.

Results

Pre and post TAVI LV function was available for 95 patients. 59% of patients were male and 10% were performed on an urgent basis. Logistic EuroSCORE was 12.53±9.2. Corevalve was used in 84% of cases. 21% required ICU admission, 20% required PPM, 4% required CVVH, 1% had a stroke. There was no change in LV function post TAVI (p=0.4) at median TTE FU of 6 months (IQR 3–24). At median clinical FU of 12 months (IQR 4–28) survival was 89% with no difference in survival between the post TAVI LV group.

Conclusion

LV function does not statistically improve post TAVI, at short-term follow-up. Survival is not affected by post TAVI LV function at mid-term follow-up. Long term echocardiographic and MRI follow-up is required to evaluate this further.