Adamo M, et al. - Researchers investigated how clinical outcomes of a large real-world population undergoing TAVI are influenced by a baseline New York Heart Association (NYHA) class IV. The emphasis was on all-cause mortality, cardiovascular mortality and re-hospitalization, assessed at the longest available follow-up and via a 3-month Landmark analysis. Other outcomes of interest were change in NYHA class, left ventricular ejection fraction, pulmonary pressure and mitral regurgitation. A significant increased risk of mortality within 3 months was observed in relation to the presence of NYHA class IV in TAVI candidates. Long-term outcomes were comparable to that of other subjects in patients with baseline NYHA IV who survived to 3 months. Irrespective of the presence of NYHA class IV, significant improvements in left ventricular systolic function, pulmonary pressure and mitral insufficiency were observed post-TAVI.