Mortality after transcatheter aortic valve replacement in young multimorbid patients as compared to an age-, gender- and comorbidity-matched background population

Pernille Steen Bække; Vilhelmas Bajoras; Jawad Butt; Thomas Pilgrim; Nicholas Joseph Montarello; Maurizio Taramasso; Didier Tchetche; Liesbeth Rosseel; Ričardas Kundelis; Kristijonas Česas; Alexander Sedaghat; Jan-Malte Sinning; Rik Adrichem; Mizuki Miura; Magdalena Erlebach; Stephan Windecker; Darren Mylotte; Raj Makkar; Emil Fosbøl; Nicolas Van Mieghem; Ole De Backer

doi:10.3389/fcvm.2025.1600790

Title	Mortality after transcatheter aortic valve replacement in young multimorbid patients as compared to an age-, gender- and comorbidity-matched background population
Authors	Bække, Pernille Steen ; Bajoras, Vilhelmas ; Butt, Jawad ; Pilgrim, Thomas ; Montarello, Nicholas Joseph ; Taramasso, Maurizio ; Tchetche, Didier ; Rosseel, Liesbeth ; Kundelis, Ričardas ; Česas, Kristijonas ; Sedaghat, Alexander ; Sinning, Jan-Malte ; Adrichem, Rik ; Miura, Mizuki ; Erlebach, Magdalena ; Windecker, Stephan ; Mylotte, Darren ; Makkar, Raj ; Fosbøl, Emil ; Van Mieghem, Nicolas ; De Backer, Ole
DOI	10.3389/fcvm.2025.1600790
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Is Part of	Frontiers in cardiovascular medicine.. Lausanne : Frontiers Media SA. 2025, vol. 12, p. [1-9].. eISSN 2297-055X
Keywords [eng]	all-cause mortality ; aortic valve stenosis ; comorbidity ; transcatheter aortic valve replacement ; young age
Abstract [eng]	Introduction: Contrary to the current guidelines patients with symptomatic severe aortic stenosis and ≤65 years of age are often referred for transcatheter aortic valve replacement (TAVR). However, the outcome after TAVR in this patient cohort remains unclear. Objectives: This study aimed to assess the rationale for denial of surgical aortic valve replacement (SAVR) in young multimorbid patients referred for TAVR, to evaluate 3-year all-cause mortality and to compare outcomes with a matched control cohort. Patients and methods: Retrospective data were collected on all consecutive patients ≤65 years of age with severe aortic stenosis treated with TAVR at 9 centres between 2010 and 2019. The TAVR-population was compared with a 1:4 age-, gender-, and comorbidity-matched population obtained from the Danish National Registries. Results: The study population consisted of 459 TAVR-recipients and 1,836 matched registry-controls. The main reasons for SAVR denial were prior cardiac surgery (35%), lung disease (30%) and frailty (23%). The 3-year all-cause mortality was 34% in the TAVR-group compared with 8% in the age-, gender- and comorbidity-matched controls with a hazard ratio (HR) of 6.5 (95% CI 4.5–9.6; P < 0.001). Patients undergoing TAVR with an active chronic disease (heart failure, lung disease, dialysis) had a 3-year all-cause mortality HR of 1.8–2.4 compared with controls. Overall, 3-year mortality rates in these distinct TAVR-subgroups were high (30%–50%) irrespective of the underlying condition. Conclusions: Young, multimorbid aortic stenosis patients aged ≤65 years and treated with TAVR between 2010 and 2019 have increased medium-term all-cause mortality compared with an age-, gender- and comorbidity-matched background population.
Published	Lausanne : Frontiers Media SA
Type	Journal article
Language	English
Publication date	2025
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„Mortality after transcatheter aortic valve replacement in young multimorbid patients as compared to an age-, gender- and comorbidity-matched background population“