BACKGROUND: Limited data is available on long-term outcomes and valve durability measures of transcatheter aortic valve implantation (TAVI).

AIMS: This study sought to assess clinical and echocardiographic outcomes of high-risk patients during the early experience of TAVI with a follow-up period extending beyond 10 years.

METHODS: Patients were included who had undergone TAVI at the Heart Center Leipzig between 2006 and 2012. Valve durability measures including moderate and severe structural valve deterioration (SVD) were defined according to the updated standardized definitions of the Valve Academic Research Consortium 3 (VARC-3).

RESULTS: A total of 1825 patients were included. The 12-year mortality rate was 92.8%. At 12 years post-TAVI, the cumulative incidence of SVD was 9.8% in the total population. Complete echocardiographic follow-up at ≥ 9 years was available for 56 patients. The median follow-up of this subgroup was 10.0 years. Moderate SVD was observed in three patients of the echocardiographic follow-up cohort (5.4%) and severe SVD in two patients (3.6%). Self-expanding (SE) transcatheter heart valves (THV) had a significantly lower rate of any SVD (2.8% vs 20.0%, p = 0.030) than balloon-expandable (BE) THV.

CONCLUSION: Long-term mortality rates in high-risk patients treated with TAVI more than 10 years ago are substantial, which limits assessment of valve durability measures. In a subgroup of survivors beyond 9 years, the cumulative incidence of SVD was low.