Transcatheter aortic valve replacement (TAVR) has been shown to be a safe and effective treatment option for nonagenarians—patients in their nineties—suffering from severe aortic stenosis (AS), according to a recent study published in The American Journal of Cardiology. The research offers crucial insights into the viability of TAVR for an aging population often excluded from clinical trials.
The study, conducted in Finland, tracked 183 patients who underwent TAVR between August 2009 and September 2021. The mean age of participants was 91.3 years, with 62.8% being women. The average EuroSCORE II, a measure of cardiac operative risk, was 6.0. The study found that transfemoral access was predominantly used, with only two patients requiring transaortic or subclavian approaches.
Key Outcomes and Complications
Researchers reported a 30-day mortality rate of 5.5% and a 30-day stroke rate of 3.8%. Major or life-threatening bleeding events occurred in 12% of patients, while 17.5% experienced major vascular complications. The rate of permanent pacemaker implantation within 30 days was 10.4%.
Survival Rates and Recovery
The one-year mortality rate was 11.6%. Investigators noted that the survival rate observed in the months following the procedure suggested the possibility of rapid recovery after TAVR, even in very elderly patients.
Implications for Clinical Practice
As the global population ages, an increasing number of individuals in their nineties will require aortic valve replacement for severe aortic stenosis. This study supports TAVR as a reasonable treatment option for these patients, providing evidence of its safety and effectiveness in a demographic often underrepresented in clinical research. The data suggests that TAVR can offer meaningful benefits and improved survival for nonagenarians with symptomatic aortic stenosis.
