Contemporary short- and mid-term outcomes of transcatheter aortic valve replacement for nonagenarians in Japan

Objectives: The large-scale adoption of transcatheter aortic valve implantation (TAVI) and aging of the population in Japan have led to an increase in the number of TAVI procedures among elderly patients. However, the clinical outcomes of TAVI for nonagenarians in Japan are unclear. The aim of this study was to clarify the outcomes of TAVI in nonagenarians with severe aortic stenosis in a real-world Japanese setting. Methods: This study retrospectively assessed the early and mid-term clinical outcomes after TAVI in nonagenarians (group N; n=23) in comparison to those of younger patients (group Y; n=117). Results: There were no postoperative deaths in either group. Although patients in group N required longer hospital stays (19±32.1 days vs. 12.1±9.3 days, p=0.04), all other early outcomes were equivalent in the two groups. The overall survival at 5 years tended to be lower in group N but the difference was not statistically significant (29.5% vs. 51.1%, p=0.26). The freedom from cardiac events at 5 years rate was equivalent in both groups (69.5% vs. 66.0%, p=0.68). There were no late cardiac deaths in group N. The freedom from late cardiac death rate at 5 years was 100% in group N and 84.6% in group Y. Conclusions: The early and mid-term clinical outcomes of TAVI in nonagenarians were comparable to those in younger patients. These results indicate that TAVI is effective for aortic stenosis in Japanese nonagenarians and may help prevent cardiac deaths.