Home > Journals > Minerva Cardiology and Angiology > Past Issues > Minerva Cardiology and Angiology 2023 June;71(3) > Minerva Cardiology and Angiology 2023 June;71(3):324-32



Publishing options
To subscribe PROMO
Submit an article
Recommend to your librarian


Publication history
Cite this article as



Minerva Cardiology and Angiology 2023 June;71(3):324-32

DOI: 10.23736/S2724-5683.22.06040-9


language: English

Transcatheter aortic valve implantation in patients with age ≤70 years: experience from two leading structural heart disease centers

Marco RUSSO 1 , Nicola CORCIONE 2, Antonio G. CAMMARDELLA 1, Federico RANOCCHI 1, Antonio LIO 1, Guglielmo SAITTO 1, Francesca NICOLÒ 1, Amedeo PERGOLINI 1, Vincenzo POLIZZI 1, Paolo FERRARO 3, Alberto MORELLO 2, Michele CIMMINO 2, Michele ALBANESE 3, Luisa NESTOLA 2, Giuseppe BIONDI-ZOCCAI 4, 5, Martino PEPE 6, Luca BARDI 2, Arturo GIORDANO 2, Francesco MUSUMECI 1

1 Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Rome, Italy; 2 Cardiovascular Interventional Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy; 3 Unit of Hemodynamics, Santa Lucia Hospital, San Giuseppe Vesuviano, Naples, Italy; 4 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy; 5 Mediterranea Cardiocentro, Naples, Italy; 6 Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is emerging as an appealing management strategy for patients with severe aortic stenosis at intermediate, high or exceedingly high risk, but its risk-benefit profile in younger patients is less certain. We aimed to explore the outlook of patients aged 70 years or less and undergoing TAVI at 2 high-volume Italian institutions.
METHODS: We retrospectively collected baseline, imaging, procedural and outcome features of patients with age ≤70 years in whom TAVI was attempted at participating centers between 2012 and 2021. Non-parametric tests and bootstrap resampling were used for inferential purposes.
RESULTS: A total of 39 patients were included, out of >3000 screened with heart team involvement and >1500 receiving TAVI. Most common or relevant indications for TAVI reduced life expectancy (e.g. cardiogenic shock or severe left ventricular systolic dysfunction), chronic obstructive pulmonary disease, morbid obesity, active or recent extra-cardiac cancer, porcelain aorta, neurologic disability, cirrhosis, or prior surgical aortic valve replacement, as well as extreme cachexia, and Hutchinson-Gilford progeria. At least two contemporary high-risk features were present in most cases. Transapical access was used in 5 (12.8%) cases, and a sheathless approach in 15 (38.5%). A variety of devices were used, including both balloon- and self-expandable devices. Clinical outcomes were satisfactory, despite the high-risk profile, at both short- and mid-term, with no in-hospital death, and 5.1% (95% confidence interval 0-12.8%) mortality at a median follow-up of 15 months (minimum 1; maximum 85). Notably, no case of significant valve deterioration requiring reintervention occurred.
CONCLUSIONS: In carefully selected patients with 70 years or less of age and prohibitive risk for surgery or reduced life expectancy, TAVI represents a safe option with a favorable mid-term survival and low rate of adverse events.

KEY WORDS: Age factors; Aortic valve stenosis; Transcatheter aortic valve implantation; Transcatheter aortic valve replacement

top of page