Outcomes of Balloon-Expandable Transcatheter Aortic Valve Replacement in Younger Patients in the Low-Risk Era

作者：Megan Coylewright, Kendra J. Grubb, Suzanne V. Arnold, Wayne Batchelor, Abhijeet Dhoble, Aaron Horne, Martin B. Leon, Vinod H. Thourani, Tamim Nazif, Brian R. Lindman, Molly Szerlip · 发表于：JAMA Cardiology · 年份：2024 · DOI：10.1001/jamacardio.2024.4237 · 被引用次数：42 · 研究领域：Cardiac Valve Diseases and Treatments、Congenital Heart Disease Studies、Aortic Disease and Treatment Approaches

Importance: Guidelines advise heart team assessment for all patients with aortic stenosis, with surgical aortic valve replacement recommended for patients younger than 65 years or with a life expectancy greater than 20 years. If bioprosthetic valves are selected, repeat procedures may be needed given limited durability of tissue valves; however, younger patients with aortic stenosis may have major comorbidities that can limit life expectancy, impacting decision-making. Objective: To characterize patients younger than 65 years who received transcatheter aortic valve replacement (TAVR) and compare their outcomes with patients aged 65 to 80 years. Design, Setting, and Participants: This retrospective registry-based analysis used data on 139 695 patients from the Society for Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry, inclusive of patients 80 years and younger undergoing TAVR from August 2019 to September 2023. Intervention: Balloon-expandable valve (BEV) TAVR with the SAPIEN family of devices. Main Outcomes and Measures: Comorbidities (heart failure, coronary artery disease, dialysis, and others) and outcomes (death, stroke, and hospital readmission) of patients younger than 65 years compared to patients aged 65 to 80 years. Results: In the years surveyed, 13 849 registry patients (5.7%) were younger than 65 years, 125 846 (52.1%) were aged 65 to 80 years, and 101 725 (42.1%) were 80 years and older. Among those younger than 65, t...