Short- and mid-term outcome of transcatheter aortic valve implantation in patients with advanced age.

In patients treated with transcatheter aortic valve implantation (TAVI), age is recognized as one of the most important risk factors. The aim of our study was to evaluate whether early and midterm results of TAVI were worse in patients over 85 year old compared with the younger population. Methods: From September 2010 to November 2015, 162 consecutive patients (mean age 78.4 +/- 7.1 years, 47.5% females) underwent TAVI in our Institution. Patients were divided into two groups: 1) elderly (>= 85 year old) and 2) younger patients (< 85 year old). Primary clinical study endpoints were the following: death, myocardial infarction, stroke, major and minor access site, and bleeding complications. The secondary endpoints included: pacemaker implantation rate, paravalvular leakage, acute kidney injury, and duration of hospitalization. Results: Twenty-six patients were 85 or older (mean 87.5 +/- 2.1). In the remaining 136 (84%), the average age was 76.7 +/- 6.4. Baseline clinical profiles were similar in both groups, though history of previous cardiac surgery (p = 0.0047) and chronic obstructive pulmonary disease (p = 0.0099) were more common in the younger group, and glomerular filtration rate was lower in the older group (p = 0.045). Major, life threatening and minor bleeding complications, as well as vascular access site complications did not differ between the two groups. Rates of myocardial infarction and stroke were comparably low in both groups. Similar results were also found in the incidence of secondary endpoints. In-hospital mortality and 1-year mortality did not differ between groups. Conclusions: TAVI in patients aged 85 and older is still a relatively safe procedure and age itself should not be a discriminatory factor in TAVI qualification.