Transcatheter aortic valve implantation in patients with an extremely small native aortic annulus: The OCEAN-TAVI registry

Fumiaki Yashima, Masanori Yamamoto, Makoto Tanaka, Ryo Yanagisawa, Takahide Arai, Hideyuki Shimizu, Keiichi Fukuda, Yusuke Watanabe, Toru Naganuma, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Kentaro Hayashida

研究成果: Article査読

19 被引用数 (Scopus)

抄録

Background Transcatheter aortic valve implantation (TAVI) has been reported to be advantageous over surgical aortic valve replacement owing to the low incidence of prosthesis-patient mismatch (PPM) and large effective orifice area (EOA). However, data on TAVI for extremely small annuli are limited. The present study aimed to compare post-procedural hemodynamics and morphology between 20-mm and 23-mm Sapien XT (SXT) transcatheter heart valves (THVs) with extremely small annuli (< 314 mm2). Methods All patients with severe aortic stenosis treated with TAVI at eight Japanese centers between October 2013 and January 2016 were prospectively included in the Optimized CathEter vAlvular iNtervention (OCEAN-TAVI) registry. In the overall cohort of 20-mm (19 patients) and 23-mm SXTs (492 patients) with extremely small annuli, the patient groups were matched one-to-one using propensity scores, and post-procedural echocardiography and multidetector computed tomography data were compared for 18 matched patients from each group (matched cohort). Results In the matched cohort, the mean gradient was higher (15.4 ± 4.1 vs. 12.2 ± 4.8 mm Hg, p = 0.04), EOA was lower (1.22 ± 0.25 vs. 1.44 ± 0.37 cm2, p = 0.02) and THV area was lower (245.6 ± 19.1 vs. 298.5 ± 33.3 mm2, p < 0.01) in the 20-mm group than in the 23-mm group. However, all patients in both groups were asymptomatic. Although moderate PPM was more prevalent in the 20-mm group than in the 23-mm group (31.6% vs. 7.9%, p < 0.01), the incidence of severe PPM was low and similar between the groups (0% vs. 0.4%, p = 1.00) in the overall cohort. Conclusion A 20-mm SXT in patients who require a small bioprosthesis leads to favorable short-term outcomes.

本文言語English
ページ(範囲)126-131
ページ数6
ジャーナルInternational Journal of Cardiology
240
DOI
出版ステータスPublished - 2017 8 1

ASJC Scopus subject areas

  • 循環器および心血管医学

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