Comparison of outcomes between nonagenarians and younger patients undergoing transcatheter aortic valve replacement (TAVR) with the lotus valve.

Introduction: Nonagenarians are reported to have high periprocedural risk following TAVR. Outcomes in nonagenarians following LOTUS valve implantation is currently not known. Objective(s): Investigate the clinical outcomes of nonagenarians following TAVR with the LOTUS valve. Method(s): Consecutive patients with LOTUS valve implantation at a single tertiary hospital were divided into two groups (nonagenarian group >= 88 yrs and control group < 88 years). Data was collected on baseline demographics, periprocedural complications and 30-day follow-up. Primary endpoint was mortality and rates of stroke and myocardial infarction. Secondary endpoints included procedure time, length of stay and complications. Result(s): Total of 104 patients (Nonagenerians n = 23 mean age 90.6 +/- 2.6 yrs, control group n = 81 patients with mean age 81.1 +/- 4.6 yrs). Baseline characteristics were similar in both groups except for more hypertensives in the controls (p=0.013). Surgical risk was higher in the nonagenarian group (mean STS score 5.7 vs 3.6% p<0.001). There was one death, no myocardial infarcts and one disabling stroke in both groups (p=0.337). Procedure time, length of stay and rates of new pacemakers were similar in nonagenarians and controls (120.4 vs 133.8 min, p=0.073), (mean 9.7 vs 9.5 days, p=0.888) and (30% vs 22% p=0.416) respectively. There was a higher proportion of patients in the nonagenarian group requiring rehabilitation (43% vs 22% p=0.046). Conclusion(s): Nonagenarians may have similar outcomes and length of stay with increased rates of rehabilitation when compared to younger patients post LOTUS valve implantation. (Table presented).