• Anthony Matta, Thibault Lhermusier, Fréderic Bouisset, Francisco-Campelo Parada, Meyer ELBaz, Vanessa Nader, Stephanie Blanco, Jerome Roncalli, and Didier Carrié.
• Department of Cardiology, University Hospital Toulouse, Rangueil, France; Faculty of Medicine, Holy Spirit University of Kaslik, Jounieh, Lebanon. Electronic address: dr.anthonymatta@hotmail.com.
• Am. J. Med. 2022 Jun 1; 135 (6): 745-751.

BackgroundGiven that life expectancy has improved, nonagenarians have become a significant proportion of world population. As aortic stenosis is primarily a disease of the elderly, the need for invasive cardiac approaches is expected to increase in people of extreme age. Herein, we compare the in-hospital adverse clinical outcomes and mortality after transcatheter aortic valve implantation (TAVI) procedures in nonagenarians to younger than 90 year old patients.MethodsA retrospective study was conducted on 1336 patients who underwent TAVI between January 2016 and March 2020 at Toulouse University Hospital, Rangueil, France. Post-TAVI adverse clinical outcomes were defined according to Valve Academic Research Consortium-2 Criteria. The studied population was divided into 2 groups according to age.ResultsOut of 1336 patients, 250 (18.7%) were nonagenarians with a mean age of 91.8 ± 1.9 years. Pacemaker implantation (12.4% vs 12.1%), stroke (2% vs 1.8%), and major vascular complications (9.2% vs 6.7%) were more common in nonagenarians, whereas acute kidney injury (1.2% vs 2.7%) and major bleeding events (3.2% vs 3.4%) were more common in the <90-year-old group. Nonagenarians are more likely to develop major vascular complications (odds ratio [OR] = 1.76 95% confidence interval [CI] 1.04-3, P = .03). The prevalence of in-hospital mortality in nonagenarians and <90-year-old patients were 5.2% and 2%, respectively. Survival analysis showed a significant difference in mortality during hospitalization period only ( P = .04).ConclusionThe prevalence of TAVI procedural success is remarkably high in nonagenarians and comparable to that of younger patients. However, the in-hospital mortality rate was 2-fold more than that of <90-year-old patients.Copyright © 2022 Elsevier Inc. All rights reserved.

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