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Eur Heart J. 2017 Sep 21;38(36):2717-2726. doi: 10.1093/eurheartj/ehx294.

SOURCE 3: 1-year outcomes post-transcatheter aortic valve implantation using the latest generation of the balloon-expandable transcatheter heart valve.

Author information

Department of Cardiothoracic Surgery, King's Health Partners, King's College Hospital, Denmark Hill, London SE5?9RS, UK.
Department of Internal Medicine, Municipal Hospital, Moltkestrasse 90, 76133 Karlsruhe, Germany.
Department of Cardiac Surgery, Mid German Heart Centre, University Hospital, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany.
Department of Cardiovascular Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.
Department of Cardiology, Clinique Pasteur, 45, avenue du Lombez BP 27617, 31076 Toulouse Cedex 3, France.
Department of Cardiology/Angiology, University Heart Centre, Südring 15, 79189 Bad Krozingen, Germany.
Department of Cardiac, Thoracic and Vascular Sciences, University Padua, Via 8 febbraio 2, 35122 Padova, Italy.
Department of Cardiology, CiberCV Hospital Ramon y Cajal, Carretera de Colmenar Viejo KM 9, 28034 Madrid, Spain.
Department of Cardiology, Hopital Bichat, 46 Rue Henri Huchard, 75018 Paris, France.



Transcatheter aortic valve implantation (TAVI) has developed from a procedure for patients with aortic stenosis inoperable or high risk for surgery, into a treatment option even for intermediate risk elderly patients. This development has been facilitated by the clinical learning curve and constant improvements of transcatheter heart valves used. We present total 1-year results of SOURCE 3, the European post-approval multicentre registry of the latest generation balloon expandable SAPIEN 3TM (Edwards Lifesciences, Irvine, CA, USA).

Methods and results:

Participating centres have submitted their consecutive experience with the SAPIEN 3, dependent on patients consent. Data were prospectively collected and all end point-related outcomes adjudicated according to VARC-2 definitions by an independent committee. Between July 2014 and October 2015, in total 1946 patients (mean age 81.6 ± 6.7 years, 52% male) were enrolled in 80 centres from 10 European countries. At 1 year, all-cause mortality was 12.6%, cardiovascular mortality 8.0%, stroke 3.1%, disabling stroke 1.4%, and rate of new pacemakers 13.2%. Causes of death were 62.0% cardiovascular and 38.0% non-cardiovascular, with heart failure (13.4%) and pulmonary complications (12.7%) being the main reasons for fatal outcomes. Multivariable analysis identified New York Heart Association Class IV and renal insufficiency as predictors of mortality, while higher BMI's improved survival. Severe (zero) and moderate paravalvular leakage (2.6%) was rare at 1 year.


In SOURCE 3, we observe a low complication rate and mortality at 1 year. Given the low incidence of higher degree paravalvular leakages, this variable did no longer affect outcome. number: NCT02698956.


Aortic stenosis; Balloon expandable valve; Causes of death; Predictors of mortality; SAPIEN 3; Transcatheter aortic valve implantation

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