Predictors of early and late mortality after transcatheter aortic valve implantation: a multicenter retrospective Chinese study

Background:
Patients undergoing TAVR constitute a high-risk population given their comorbidities and out-of-hospital mortality rates remain high despite significant improvements in the overall procedural outcomes.

Objectives:
The objective of this study was to determine the early and late mortality rates following transfemoral transcatheter aortic valve replacement (TAVR) and identify the risk factors for poor outcomes.

Methods:
This study population examined patients extracted from 43 publicly funded hospitals in Hong Kong between 2010 and 2019. The study constitutes retrospective analysis of mortality outcomes for severe aortic stenosis patients undergoing TAVR. The primary end points include out-of-hospital 30-day, 1-year, 1–2-year, and 2–5-year mortality rates.

Results:
A total of 448 patients underwent TAVR and were included into the study. The rates of mortality following TAVR were 1.7%, 3.3%, 1.3%, and 0.22% at 30 days, 1, 1–2, and 2–5 years, respectively. Age and chronic renal failure (CRF) were concluded to be associated with postprocedural mortality. Further analysis of the baseline echocardiographic parameters revealed a higher prevalence of right atrial enlargement (RAE) and tricuspid and pulmonary regurgitation in the deceased subgroup.

Conclusion:
We report the 30-day, 1-, 1–2-, and 2–5-year all-cause mortality for TAVR of 1.7%, 3.3%, 1.3%, and 0.22% at 30 days. Factors associated with a higher prevalence of mortality include age, CRF, RAE, and tricuspid and pulmonary regurgitation.