Objective: The long-term durability of transcatheter aortic bioprosthetic valves continues to be a major concern. Standardized criteria of the structural valve deterioration (SVD) and bioprosthetic valve failure (BVF) have recently been defined. Limited studies have evaluated the longterm durability of transcatheter aortic valve implantation (TAVI) according to these new definitions. We aim to analyze the durability of TAVI beyond 5 years and to report the frequency of SVD and BVF. Methods: A total of 89 patients who had undergone TAVI and had theoretically completed at least 5 years after the procedure were included. Either a Medtronic CoreValve or an Edwards SAPIEN XT valve were implanted in the patients. New standardized definitions were used to evaluate SVD and BVF. Results: The mean age of the patients was 78.70 +/- 6.95 years. SVD occured in 4 (4.5%) patients during 6 years of follow-up. Severe SVD was observed in 2 patients (2.2%), and these patients had the New York Heart Association class II symptoms. Both patients with severe SVD also met the criteria of BVF. Moderate SVD was observed in 2 patients (2.2%), and these patients had no valve-related symptoms. Of the 4 SVD cases, 2 were associated with increased mean transaortic gradients, whereas the remaining 2 cases were associated with intraprosthetic aortic regurgitation. All patients with SVD are still alive, and none of them have required aortic valve reintervention. Conclusion: Although first-generation TAVI devices were used, we determined the low rate of SVD and BVF at the 6-year follow-up. It may be suggested that there is no major concern associated with TAVI even with first-generation devices regarding long-term durability.

Background and Objectives: Transcatheter aortic valve implantation (TAVI) has become the mainstay of treatment for symptomatic aortic stenosis (AS) in patients over 70 years of age. It is also indicated for younger patients with significant comorbidities, for valve-in-valve interventions, and in selected patients with severe aortic insufficiency. We aimed to evaluate procedural and clinical outcomes of transfemoral TAVI performed over the course of 12 years by the same operators using different bioprosthetic valves. Materials and Methods: Between 2012 and 2023, 375 patients underwent TAVI in our clinic, with six types of bioprosthetic valves (Edwards Sapien XT, Medtronic Valves [CoreValve and Evolut R], Portico, Myval, Acurate Neo, and Direct Flow Medical). A transfemoral approach was used in all patients. The procedural and clinical outcomes were defined according to Valve Academic Research Consortium-3 (VARC-3) criteria. Results: The mean age of the patients was 78.4 ± 7.3, and their median STS score was 4.2 (2.9–5.9). Of the 375 patients, 361 had severe AS, 4 had severe aortic insufficiency, 5 were valve-in-valve, and 5 were valve-in-TAVI. Seven patients required a second valve implantation: four due to embolization of the prosthetic valve and three due to deep implantation of the prosthetic valve. Based on the VARC-3 criteria, the rates of technical success and device success were 90.4% and 85.3%, respectively. Major vascular complications were observed in 18 (4.8%) patients. Also, 42 (11.2%) patients required permanent pacemaker implantation. The incidence of moderate or worse paravalvular leak was 2.9%. The peri-procedural, 30-day, 1-year, and 5-year mortality rates were 5.1%, 4.3%, 15.2%, and 45.6%, respectively. STS scores (HR:1.129, 95%CI: 1.068–1.192, p < 0.001) and post-TAVI acute kidney injury (HR:3.993, 95%CI:1.629–9.785, p = 0.002) were detected as independent predictors of mortality in Cox regression analysis. Conclusions: This registry demonstrated the evolution of TAVI procedures at a single center over 12 years. A high level of collaboration between experienced operators and innovations in devices seem to be the key features for achieving high procedural success and low complication rates.

Preparticipation screening of athletes by electrocardiography is the most crucial step in determining sudden cardiac death risk factors. Several electrocardiography interpretation software programs have been developed for physicians practicing in this field. Our study aimed to assess cardiopoint sudden death screening module by comparing its findings with two cardiologists using Seattle and International criteria.

Background: Transcatheter aortic valve implantation (TAVI) is a viable alternative therapeutic approach for patients with severe aortic stenosis (AS), following technological innovations in transcatheter aortic valve systems and advances in clinical expertise, which aim to optimize valve hemodynamics. In this study, we aimed to compare early hemodynamic changes in different types of TAVI valves via two-dimensional echocardiography. Methods: This retrospective observational study examined patients with severe AS who underwent transfemoral TAVI. Patients were classified according to expansion mechanism (self-expanding valves (SEVs) or balloon-expandable valves (BEVs)) and leaflet position relative to the annulus (supra-annular valves (SAVs) or intra-annular valves (IAVs)). The implanted prostheses were Edwards SAPIEN XT valves (ESV, Edwards Lifesciences, Irvine, CA, USA), Medtronic valves (Core Valve-MCV and Evolut R, Medtronic, Minneapolis, MN, USA), Portico valves (St. Jude Medical, Saint Paul, MN, USA), and Myval valves (Meril Life Sciences, Vapi, India). Baseline two-dimensional transthoracic echocardiography (TTE) datasets were compared with post-TAVI measures obtained before discharge. Results: In total (n = 332), 275 (82.8%) patients were treated with SEVs, and 57 (17.2%) were treated with BEVs. In terms of leaflet position, 249 (75%) patients were treated with SAVs, and the remaining 83 (25%) patients were treated with IAVs. Transaortic gradients were comparable between patients treated with SEVs and BEVs. However, patients treated with IAVs exhibited significantly higher aortic maximum gradients (16 [13–21] mmHg vs. 14 [10–20] mmHg, p = 0.019) and mean gradients (9 [7–11] mmHg vs. 8 [5–10] mmHg, p = 0.014) compared to those receiving SAVs. Post-TAVI gradients were also compared based on each TAVI device. Although post-TAVI aortic maximum gradient was comparable among TAVI devices (p = 0.080), aortic mean gradient was significantly different among the valves (p = 0.006). Post hoc analyses demonstrated that the post-TAVI mean gradient was significantly lower in Medtronic CoreValve compared to the Myval (p = 0.013) and Portico (p = 0.030). No significant differences were observed in the frequency of perivalvular leak between the valve groups. Conclusions: We found that post-TAVI transaortic gradients of SEVs and BEVs were comparable; however, SAVs were associated with lower transaortic gradients than those of the IAVs. In addition, the frequency of ≥moderate PVL was comparable between the valve groups.