Overview

• The retrospective review covered 2012–2022 procedures and included 2,123 patients with complete echocardiographic follow-up.
• Early hemodynamic valve deterioration at one year occurred in more than 6% of patients under standardized definitions.
• Younger age and smaller aortic annuli were associated with higher risk, with smaller implanted valve sizes linked to deterioration while larger valves appeared protective.
• Prior surgical aortic valve replacement was independently associated with early deterioration.
• Those with one-year deterioration had a nearly fourfold higher five-year aortic valve reintervention rate at 2.3% versus 0.6%, underscoring the need for vigilant long-term follow-up and careful valve selection.