Results:

All-cause mortality rates at 1, 2, 3, 4, and 5 years were 21%, 29%, 38%, 48%, and 55%, respectively; cardiovascular mortality rates were 10%, 14%, 19%, 23%, and 28%, respectively. The overall neurological event rate at 5 years was 7.5%, of which more than two-thirds occurred early after the procedure. During follow-up, there were 241 re-hospitalizations for cardiovascular reasons in 164 (46%) patients. Among all re-hospitalizations, acute heart failure was the most frequently reported (42.7%), followed by requirement of permanent pacemaker implantation (17.4%). On echocardiography, mean transaortic gradients decreased from 55.6 ± 16.8 mm Hg (pre-TAVR) to 12.8 ± 10.9 mm Hg (5-years post-TAVR) (p < 0.001). Late prosthesis failure occurred in five cases (1.4%); among these, redo TAVR was successfully carried out in two patients (0.6%) presenting with symptomatic prosthesis restenosis. The remaining three cases of prosthesis failure did not undergo further invasive interventions. Ten patients (2.8%) had evidence of late mild stenosis, with a mean transaortic gradient ranging from 20 to 40 mm Hg. No other cases of structural or nonstructural valvular deterioration were observed. Valve thrombosis or late valve embolization were not reported.