Quality of life has become an important outcome measure after transcatheter aortic valve implantation (TAVI), yet the long-term impact of early postprocedural complications remains uncertain. In a prespecified substudy of the LANDMARK trial presented at the EuroPCR 2026 meeting, investigators evaluated the association between early non-fatal complications, 1-year mortality, and quality-of-life outcomes after TAVI.
LANDMARK was a randomized TAVI trial conducted across Europe, New Zealand, and Brazil. The current analysis included 742 patients who survived the first 30 days after TAVI. Early non-fatal complications included stroke, major bleeding, major vascular complications, acute kidney injury, moderate or severe prosthetic valvular regurgitation, and new permanent pacemaker implantation occurring within 30 days of the procedure.
Findings
- Among 742 patients alive at 30 days, 176 experienced at least one early non-fatal complication and 566 had no early complications.
- One-year mortality was higher among patients with early complications than among those without complications (8.0% vs 3.9%; P = 0.03).
- Quality-of-life analyses were available for 662 patients with baseline and 1-year Short Form-12 (SF-12) assessments.
- Physical component summary (PCS) scores improved similarly in patients with and without early complications (+6.9 vs +6.8 points; P = 0.93).
- Mental component summary (MCS) scores also improved in both groups, with no significant difference between patients with and without early complications (+6.7 vs +4.7 points; P = 0.17).
Early non-fatal complications after TAVI were associated with increased 1-year mortality. However, among patients surviving to follow-up, improvements in physical and mental quality of life were similar regardless of early complication status.
