Objective

Transcatheter Aortic Valve Implantation (TAVI) has now become an established procedure for severe symptomatic aortic stenosis in patients unsuitable for an AVR. There is variable practice on the choice of prosthesis used and team dynamics, including selection criteria. Hence outcome from TAVI can be variable based on centre. We aim to evaluate the outcome of TAVI in our centre over a 7 year period.

Methods

Case notes for all 257 consecutive TAVIs from April 2008 – March 2015 were assessed retrospectively. Patients were routinely followed up in the outpatients clinic and Transthoracic echocardiography (TTE) performed. Paravalvular leak (PVL) was classified into ≥ mild (group 1) and < mild (group 2). Statistical analysis was performed for survival.

Results

56% were male and 15% were performed urgently. 66% were NYHA class III and 64% had good LV. 27% were in cardiac failure at the time of TAVI. The Corevalve was used in 77% of cases and Lotus in 11%. 20% required ICU, 23% required PPM, 3% required CVVH and 2% had a stroke. 12% had moderate PVL. In-patient stay was 10 days (IQR 5–13). Survival was 86% at median FU of 12 months (IQR 4–26) and median survival was 16 months (IQR 6–34). There was no difference in survival between group 1 and 2 (p=0.9).

Conclusion

In our 7-year experience, TAVI with the Corevalve is safe and is associated with good haemodynamic performance. At median follow-up survival is good. Percentage of moderate paravalvular leak is low and mild PVL has no impact on survival. Further robust echocardiographic and MRI follow-up is essential to evaluate long-term durability and outcomes.