The differential outcomes across the age spectrum of transcatheter aortic valve implantation (TAVI) recipients are still debated. Aim of the study was to evaluate the clinical outcomes of oldest-old patients undergoing TAVI in the large “Registro Italiano GISE sull'impianto di Valvola Aortica Percutanea (RISPEVA)” registry. A total of 3,507 patients were stratified according to age: 1,381 were ≥85 years, 2,126 were <85 years. Primary endpoints were death at 30-days and complete follow-up (FU) (medium 368 days). Cerebrovascular events, myocardial infarction, bleedings, vascular complications at 30-days and complete FU were considered. In the unadjusted analysis, 30-days mortality in the oldest-old group was higher than in younger patients (4.2% vs 2.4%; p = 0.007); this difference kept true also at complete FU (19.6% vs 15.9%; p = 0.014). After propensity score (PS) matching, the oldest-old population showed a higher mortality solely at 30-days (4.7% vs 2.4%; p = 0.016), while the survival at complete FU was similar to that of younger patients (20.1% vs 18.0%; p = 0.286). The incidence of non-fatal outcomes resulted comparable between the 2 groups, also after propensity score matching. At the multivariate logistic regression analysis procedural major or disabling bleedings, cerebrovascular events, cardiogenic shock resulted predictors of 30-days death in the oldest-old cohort. In conclusion, patients ≥85 years can safely undergo TAVI being not more exposed to procedural complications than those <85 years; nevertheless they showed worse 30-days mortality, probably driven by reduced tolerance to complications. Passed the critical periprocedural phase, patients ≥85 years had a similar survival to those <85 years with comparable risk profile.

跨导管主动脉瓣植入术（TAVI）接受者年龄谱的不同结果仍存在争议。这项研究的目的是评估大型“ Registro Italiano GISE sull'impianto di Valvola Aortica Percutanea（RISPEVA）”注册表中接受TAVI治疗的最老患者的临床结局。共有3,507名患者按年龄分层：≥85岁的有1,381名，<85岁的有2,126名。主要终点是30天死亡和完整随访（FU）（中度368天）。考虑30天的脑血管事件，心肌梗塞，出血，血管并发症和完全FU。在未经校正的分析中，年龄最大的组的30天死亡率高于年轻的患者（4.2％对2.4％； p = 0.007）；在完全FU时，这一差异也适用（19.6％对15.9％； p = 0.014）。倾向得分（PS）匹配后，最老的人群仅在30天时显示较高的死亡率（4.7％对2.4％； p = 0.016），而完全FU的存活率与年轻患者相似（20.1％）对比18.0％； p = 0.286）。倾向评分匹配后，两组非致命性结局的发生率相当。在多因素logistic回归分析中，程序性大出血或致残性大出血，脑血管事件，心源性休克导致最老的队列中有30天死亡的预测因素。总之，≥85岁的患者可以安全地接受TAVI治疗，而<85岁的患者不会遭受更多的手术并发症。然而，他们的30天死亡率却较差，这可能是由于对并发症的耐受性降低所致。通过了关键的围手术期