Feasibility of Transcatheter Aortic Valve Implantation in Patients With Very Severe Aortic Stenosis.

Autor:	Kobayashi Y; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Izumo M; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Okuyama K; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Uenomachi N; Ultrasound Center, St. Marianna University School of Medicine Kawasaki Japan., Shoji T; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Kai T; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Okuno T; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Sato Y; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Kuwata S; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Koga M; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Ishibashi Y; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Tanabe Y; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan., Miyairi T; Department of Cardiovascular Surgery, St. Marianna University School of Medicine Kawasaki Japan., Akashi YJ; Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan.
Jazyk:	angličtina
Zdroj:	Circulation reports [Circ Rep] 2023 Aug 04; Vol. 5 (9), pp. 358-364. Date of Electronic Publication: 2023 Aug 04 (Print Publication: 2023).
DOI:	10.1253/circrep.CR-23-0063
Abstrakt:	Background: Very severe aortic stenosis (AS) has a poor prognosis even in asymptomatic patients, and asymptomatic very severe AS is a Class IIa indication for aortic valve replacement, although the safety and effectiveness of transcatheter aortic valve implantation (TAVI) for very severe AS is not well-established. Methods and Results: This study included 366 patients undergoing TAVI at a single center, with 85 and 281 patients in the very severe AS (peak velocity ≥5 m/s or mean pressure gradient (PG) ≥60 mmHg) and severe AS groups, respectively. Procedural and clinical outcomes at 1-year follow-up were compared between groups. The calcium scores were significantly higher in the very severe AS group (2,864.5 vs. 1,405.8 arbitrary units [AU] (P<0.001). Although the patient-prosthesis mismatch rate was higher in the very severe AS group (38.3% vs. 25.7%; P=0.029), there was no significant difference in the early safety and clinical efficacy between the groups (16.5% vs. 17.1% and 12.0% vs. 18.9%, respectively). Similarly, there was no significant difference in all-cause mortality at 1 year (4.8% vs. 9.8%). Conclusions: Despite a higher incidence of prosthesis-patient mismatch in those with very severe AS, the procedural and clinical outcomes were comparable to those in patients with severe AS. TAVI may be a reasonable treatment option for very severe AS. Competing Interests: Y.J.A. is a member of Circulation Reports’ Editorial Team. T.O. reports speaker fees from Abbott Medical Japan and Medtronic, M.I. is a consultant of Edwards Lifesciences and Abbott Medical Japan, and S.K. is a consultant of Abbott Medical Japan. All other authors declare no conflicts of interest. (Copyright © 2023, THE JAPANESE CIRCULATION SOCIETY.)
Databáze:	MEDLINE
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