Since the first-in-man transcatheter aortic valve implantation (TAVI) performed by our group in 2002, the number of procedures has dramatically increased. Currently restricted to inoperable and high-risk patients TAVI is likely to be extended to lower risk patients. However, long-term data regarding valve durability are missing. We aimed to report our experience with long-term follow-up to assess long-term mortality and valve durability.

All consecutive patients presenting with severe symptomatic aortic stenosis treated by TAVI were included prospectively. Clinical and echocardiographic follow-up was performed at 30 days and annually thereafter. Survival curves were constructed using Kaplan-Meier analysis. We also evaluated valve durability and the incidence of infective endocarditis.

Between 2002 and 2015, 784 consecutive patients (age: 83.3±9.4 years, logistic EuroSCORE of 19.6±12.1%) underwent TAVI including 634 (80.9%) patients via a femoral approach. A balloon-expandable transcatheter heart valve (THV) was predominantly used (747 Pts; 95.3%): 68 Cribier- Edwards, 114 Sapien, 482 Sapien XT, and 83 Sapien 3 since July 2014. Thirty-day mortality dramatically decreased from 22.1% using the Cribier- Edwards in compassionate patients to 1.3% with the Sapien 3 (p<0.0001). Survival curves according to the type of valve are presented in the Figure. Mean aortic gradient remained unchanged during follow-up up to nine years, and only one patient presented with stenotic degenerated THV Sapien valve successfully treated by a valve-in-valve procedure. Four (0.5%) patients had infective endocarditis.

Long-term (up to 9 years) follow-up of our large series of patients treated by TAVI demonstrates no warning signs of valve deterioration suggesting very encouraging valve durability, using predominantly, a balloon expandable prosthesis

The author declares a conflict of interest: Hélène Eltchaninoff, Pierre-Yves Litzler and Alain Cribier are consultants for Edwards Lifesciences. Other authors have no disclosure.