Age-related outcomes of transcatheter aortic valve replacement in patients with pure severe aortic regurgitation.

Background: Transcatheter aortic valve replacement (TAVR) has emerged as the recommended treatment for older patients with pure severe aortic regurgitation (PSAR). However, the efficacy of TAVR in younger patients with aortic regurgitation (AR) remains unclear. This study explored the therapeutic efficacy and safety of TAVR in these two groups and compared their outcomes.

Methods: Patients with AR who underwent TAVR at Zhongshan Hospital between June 2021 and September 2023 were included and categorized into younger- and older age groups based on whether they were ≥75 years old. The baseline characteristics, clinical test information, and follow-up data of the patients were collected.

Results: A total of 82 patients were included in this study (72.7±7.60 years old, 52[63.4%] male). The younger and older age groups each comprised 41 patients. Young patients had better clinical conditions (diabetes mellitus [0% vs. 17.1%, p=0.006], symptoms [29.3% vs. 70.7%, p=0.025], and permanent pacemaker implantation [PPMI] [0% vs. 9.8%, p=0.040]). Significant improvements in AR as well as left and right heart functions were observed in both groups. A reduced occurrence rate of mild perivalvular leaks (PVL) was observed in the younger age group at the 1-month follow-up visit (2.4% vs. 14.6%; p=0.048).

Conclusion: TAVR is safe and effective for both younger and older patients undergoing PSAR. Younger patients who underwent AR-TAVR experienced fewer perivalvular leaks compared to those experienced by older patients. Therefore, TAVR may be an alternative for younger patients with PSAR. Further Large-scale multicenter prospective studies are needed to validate our findings.