Incidence, Predictors, and Clinical Impact of Prosthesis–Patient Mismatch Following Transcatheter Aortic Valve Replacement in Asian Patients: The OCEAN-TAVI Registry

OCEAN-TAVI investigators

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objectives: The authors sought to investigate the prevalence, risk factors, and mid-term mortality in Asian patients with prosthesis–patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR). Background: Little information is available on PPM after TAVR in Asian patients. Methods: The authors included 1,558 patients enrolled in the OCEAN-TAVI (Optimized transCathEter vAlvular iNtervention) Japanese multicenter registry from October 2013 to July 2016 after excluding patients who died following TAVR before discharge. PPM was defined as moderate if ≧0.65 but ≦0.85 cm2/m2, or severe if <0.65 cm2/m2 at the indexed effective orifice area by post-procedural echocardiography. Results: Of the 1,546 patients, moderate and severe PPM were observed in 138 (8.9%) and 11 (0.7%) patients, respectively. These 149 patients were included in the PPM group. The median age and body surface area were 85 years (interquartile range [IQR]: 81 to 88 years) and 1.41 m2 (IQR: 1.30 to 1.53 m2), respectively. In our multivariate analysis, younger age, larger body surface area, smaller aortic valve area, smaller annulus area, no balloon post-dilatation, and use of Edwards Sapien 3 (Edwards Lifesciences, Irvine, California) were identified as independent predictors of PPM. The estimated cumulative all-cause mortality at 1 year using the Kaplan-Meier method was similar between the PPM and non-PPM groups (10.2% vs. 8.3%; log-rank; p = 0.41). Conclusions: The low prevalence of PPM and mortality at 1 year in patients with PPM after TAVR in this Japanese cohort implies that PPM is not a risk factor for mid-term mortality in Asian patients who have undergone TAVR.

Original languageEnglish
Pages (from-to)771-780
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume11
Issue number8
DOIs
Publication statusPublished - 2018 Apr 23

Fingerprint

Registries
Incidence
Mortality
Body Surface Area
Transcatheter Aortic Valve Replacement
Aortic Valve
Echocardiography
Dilatation
Multivariate Analysis

Keywords

  • body surface area
  • clinical outcome
  • PPM
  • small body size
  • TAVR

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{94a2e97b3a7e492e9682e13d608ef0c5,
title = "Incidence, Predictors, and Clinical Impact of Prosthesis–Patient Mismatch Following Transcatheter Aortic Valve Replacement in Asian Patients: The OCEAN-TAVI Registry",
abstract = "Objectives: The authors sought to investigate the prevalence, risk factors, and mid-term mortality in Asian patients with prosthesis–patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR). Background: Little information is available on PPM after TAVR in Asian patients. Methods: The authors included 1,558 patients enrolled in the OCEAN-TAVI (Optimized transCathEter vAlvular iNtervention) Japanese multicenter registry from October 2013 to July 2016 after excluding patients who died following TAVR before discharge. PPM was defined as moderate if ≧0.65 but ≦0.85 cm2/m2, or severe if <0.65 cm2/m2 at the indexed effective orifice area by post-procedural echocardiography. Results: Of the 1,546 patients, moderate and severe PPM were observed in 138 (8.9{\%}) and 11 (0.7{\%}) patients, respectively. These 149 patients were included in the PPM group. The median age and body surface area were 85 years (interquartile range [IQR]: 81 to 88 years) and 1.41 m2 (IQR: 1.30 to 1.53 m2), respectively. In our multivariate analysis, younger age, larger body surface area, smaller aortic valve area, smaller annulus area, no balloon post-dilatation, and use of Edwards Sapien 3 (Edwards Lifesciences, Irvine, California) were identified as independent predictors of PPM. The estimated cumulative all-cause mortality at 1 year using the Kaplan-Meier method was similar between the PPM and non-PPM groups (10.2{\%} vs. 8.3{\%}; log-rank; p = 0.41). Conclusions: The low prevalence of PPM and mortality at 1 year in patients with PPM after TAVR in this Japanese cohort implies that PPM is not a risk factor for mid-term mortality in Asian patients who have undergone TAVR.",
keywords = "body surface area, clinical outcome, PPM, small body size, TAVR",
author = "{OCEAN-TAVI investigators} and Masaki Miyasaka and Norio Tada and Masataka Taguri and Shigeaki Kato and Yusuke Enta and Tatsushi Otomo and Masaki Hata and Yusuke Watanabe and Toru Naganuma and Motoharu Araki and Futoshi Yamanaka and Shinichi Shirai and Hiroshi Ueno and Kazuki Mizutani and Minoru Tabata and Akihiro Higashimori and Kensuke Takagi and Masanori Yamamoto and Kentaro Hayashida",
year = "2018",
month = "4",
day = "23",
doi = "10.1016/j.jcin.2018.01.273",
language = "English",
volume = "11",
pages = "771--780",
journal = "JACC: Cardiovascular Interventions",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "8",

}

TY - JOUR

T1 - Incidence, Predictors, and Clinical Impact of Prosthesis–Patient Mismatch Following Transcatheter Aortic Valve Replacement in Asian Patients

T2 - The OCEAN-TAVI Registry

AU - OCEAN-TAVI investigators

AU - Miyasaka, Masaki

AU - Tada, Norio

AU - Taguri, Masataka

AU - Kato, Shigeaki

AU - Enta, Yusuke

AU - Otomo, Tatsushi

AU - Hata, Masaki

AU - Watanabe, Yusuke

AU - Naganuma, Toru

AU - Araki, Motoharu

AU - Yamanaka, Futoshi

AU - Shirai, Shinichi

AU - Ueno, Hiroshi

AU - Mizutani, Kazuki

AU - Tabata, Minoru

AU - Higashimori, Akihiro

AU - Takagi, Kensuke

AU - Yamamoto, Masanori

AU - Hayashida, Kentaro

PY - 2018/4/23

Y1 - 2018/4/23

N2 - Objectives: The authors sought to investigate the prevalence, risk factors, and mid-term mortality in Asian patients with prosthesis–patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR). Background: Little information is available on PPM after TAVR in Asian patients. Methods: The authors included 1,558 patients enrolled in the OCEAN-TAVI (Optimized transCathEter vAlvular iNtervention) Japanese multicenter registry from October 2013 to July 2016 after excluding patients who died following TAVR before discharge. PPM was defined as moderate if ≧0.65 but ≦0.85 cm2/m2, or severe if <0.65 cm2/m2 at the indexed effective orifice area by post-procedural echocardiography. Results: Of the 1,546 patients, moderate and severe PPM were observed in 138 (8.9%) and 11 (0.7%) patients, respectively. These 149 patients were included in the PPM group. The median age and body surface area were 85 years (interquartile range [IQR]: 81 to 88 years) and 1.41 m2 (IQR: 1.30 to 1.53 m2), respectively. In our multivariate analysis, younger age, larger body surface area, smaller aortic valve area, smaller annulus area, no balloon post-dilatation, and use of Edwards Sapien 3 (Edwards Lifesciences, Irvine, California) were identified as independent predictors of PPM. The estimated cumulative all-cause mortality at 1 year using the Kaplan-Meier method was similar between the PPM and non-PPM groups (10.2% vs. 8.3%; log-rank; p = 0.41). Conclusions: The low prevalence of PPM and mortality at 1 year in patients with PPM after TAVR in this Japanese cohort implies that PPM is not a risk factor for mid-term mortality in Asian patients who have undergone TAVR.

AB - Objectives: The authors sought to investigate the prevalence, risk factors, and mid-term mortality in Asian patients with prosthesis–patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR). Background: Little information is available on PPM after TAVR in Asian patients. Methods: The authors included 1,558 patients enrolled in the OCEAN-TAVI (Optimized transCathEter vAlvular iNtervention) Japanese multicenter registry from October 2013 to July 2016 after excluding patients who died following TAVR before discharge. PPM was defined as moderate if ≧0.65 but ≦0.85 cm2/m2, or severe if <0.65 cm2/m2 at the indexed effective orifice area by post-procedural echocardiography. Results: Of the 1,546 patients, moderate and severe PPM were observed in 138 (8.9%) and 11 (0.7%) patients, respectively. These 149 patients were included in the PPM group. The median age and body surface area were 85 years (interquartile range [IQR]: 81 to 88 years) and 1.41 m2 (IQR: 1.30 to 1.53 m2), respectively. In our multivariate analysis, younger age, larger body surface area, smaller aortic valve area, smaller annulus area, no balloon post-dilatation, and use of Edwards Sapien 3 (Edwards Lifesciences, Irvine, California) were identified as independent predictors of PPM. The estimated cumulative all-cause mortality at 1 year using the Kaplan-Meier method was similar between the PPM and non-PPM groups (10.2% vs. 8.3%; log-rank; p = 0.41). Conclusions: The low prevalence of PPM and mortality at 1 year in patients with PPM after TAVR in this Japanese cohort implies that PPM is not a risk factor for mid-term mortality in Asian patients who have undergone TAVR.

KW - body surface area

KW - clinical outcome

KW - PPM

KW - small body size

KW - TAVR

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U2 - 10.1016/j.jcin.2018.01.273

DO - 10.1016/j.jcin.2018.01.273

M3 - Article

C2 - 29673509

AN - SCOPUS:85045197111

VL - 11

SP - 771

EP - 780

JO - JACC: Cardiovascular Interventions

JF - JACC: Cardiovascular Interventions

SN - 1936-8798

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