Conclusion
Concluding the data given by this study and the presently available literature, it seems to be evident that the initial clinical and hemodynamic results are satisfying. The procedure is safe and effective. Nonetheless, small true-ID’s equal or less 21mm are associated with inferior hemodynamic outcomes. Due to the high overall-mortality in the study population, a potential significant difference in long-term survival potentially is concealed. In contrast to only one available long-term-study on hemodynamic outcomes, the present study showed steadily increasing pressure gradients over time, independently from true-ID of the surgical valve or type of transcatheter prosthesis. After 3-years more than 70% of the patients did not meet the VARC-2-device success criteria anymore. This finding is a matter of concern and needs to be evaluated by further studies prior bringing VIV-TAVR into younger and lower risk patients.