Long-term clinical outcomes after TAVR in patients with oncological disease

The prevalence of both severe aortic stenosis and cancer continues to rise with an aging population, making them the leading causes of mortality. Although transcatheter aortic valve replacement (TAVR) is increasingly performed in patients with cancer, real-world data on long-term outcomes are needed.

This study aimed to evaluate long-term outcomes following TAVR based on cancer history and status.

This cohort study analysed data from the Latvian TAVR registry between 2022 and 2023, with a 24-month follow-up. The primary outcome was all-cause mortality. Secondary outcomes included in-hospital mortality, acute kidney injury (AKI), AKI requiring dialysis, and permanent pacemaker (PPM) implantation. Based on medical history, patients were divided into four groups: no history of cancer (84.6%), previous cancer (10.3%), active cancer (4.2%) and metastatic active cancer (0.9%).

A total of 213 patients were included in the analysis. Most common active cancer locations were colon (28%), lungs (18%) and kidneys (18%). There were no statistically significant changes in all-cause mortality among patients with previous cancer (Hazard ratio (HR) 0.68 (95% CI 0.22-2.01), p=0.496) and active cancer (HR 1.61 (95% CI 0.45-5.71), p=0.465). Only active metastatic cancer was found to be a statistically significant risk factor for the primary outcome (HR 8.50 (95% CI 2.01-35.88), p=0.004). There were no statistically significant differences in any of the secondary outcomes across the groups (Table 1).

Active metastatic cancer was the only significant predictor of increased 24-month all-cause mortality in TAVR patients. No significant differences were observed in secondary outcomes across the groups. Cardio-oncology plays a significant role in TAVR decision-making, requiring careful multidisciplinary evaluation to balance procedural benefit and oncologic prognosis.Table 1For image description, please refer to the figure legend and surrounding text.