Long-term survival evaluation after transcatheter aortic valve implantation in patients with severe aortic valve stenosis: a retrospective cohort study

Transcatheter aortic valve implantation (TAVI) in patients with severe aortic valve stenosis (AS) is becoming an established technique. However, data on long-term survival in Japan are limited and regional disparities remain. We aimed to evaluate long-term survival after TAVI using the Nara Kokuho Database (KDB). Patients who underwent TAVI between July 2014 and March 2023 were enrolled. The study outcomes were to evaluate survival rates after TAVI over 1-7 years and predict long-term prognostic factors using Kaplan-Meier analysis and Cox proportional hazards model. Of 446 consecutive patients, 284 were female participants (63.7%). The mean age was 84.1 ± 4.3 years. The overall survival rates were 95.1-54.4% over 1-7 years. Cox proportional hazards model analysis revealed that younger age (< 85 years, hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.20-0.69; p = 0.002) and transfemoral approach (HR, 0.37; 95% CI 0.17-0.78; p = 0.009) were predictive factors. However, renal disease (HR, 2.02; 95% CI 1.08-3.77; p = 0.03), cerebrovascular disease (HR, 2.02; 95% CI 1.13-3.63; p = 0.02), and rheumatologic disease (HR, 2.71; 95% CI 1.19-6.18; p = 0.02) were poor long-term prognostic factors. This study measured the long-term survival after TAVI using Nara KDB data, identifying factors that might serve as predictive indicators.