Transcatheter Aortic Valve Implantation in Nonagenarians: A Comparative Analysis of Baseline Characteristics and 1-Year Outcomes.

Abstract

Background: Transcatheter aortic valve implantation (TAVI) is increasingly used in elderly patients with severe aortic stenosis, yet data on nonagenarians remain limited. This study aimed to compare clinical characteristics and outcomes of patients aged ≥90 years with those aged <90 years undergoing TAVI.

Methods: We retrospectively analyzed 620 patients who underwent transfemoral TAVI. Patients were divided into two groups: <90 years (n = 545) and ≥90 years (n = 75). Baseline clinical, procedural, and outcome data were compared.

Results: Nonagenarians had lower body mass index (BMI) and a lower prevalence of comorbidities such as diabetes, hyperlipidemia, and prior coronary artery bypass grafting CABG (all p < 0.05). All-cause mortality was higher in nonagenarians at 1 month (8.0% vs. 5.5%, p = 0.425), 6 months (9.3% vs. 7.9%, p = 0.838), and 1 year (21.3% vs. 16.7%, p = 0.405), though these differences were not statistically significant. In-hospital stroke occurred more frequently in patients ≥ 90 years (6.7% vs. 2.2%, p = 0.044).

Conclusions: Despite a higher rate of in-hospital stroke, nonagenarians undergoing TAVI had comparable mortality outcomes to younger patients. These findings support the feasibility of TAVI in selected very elderly patients, while highlighting the need for tailored stroke prevention strategies.

Trial registration: The trial is retrospectively registered, and a clinical trial number is not applicable.