Transcatheter aortic valve implantation: first trans-iliac experience in Japan.

Conventional aortic valve replacement (AVR) is the gold standard surgical treatment for symptomatic aortic valve stenosis. However, some patients are not referred for open surgical procedure because of their high risk due to complicated co-morbidities. We describe the first case in Japan of successful transcatheter aortic valve implantation (TAVI). An 81-year-old woman with severe interstitial pneumonia was referred for significant aortic valve stenosis. Conventional AVR might have been risky, so TAVI was planned after informed consent was obtained. Under general anesthesia was established, a 23-mm Edwards SAPIEN transcatheter heart valve was implanted through the common iliac artery. Postoperative echocardiographic assessment showed satisfactory hemodynamic function with a stable valve position, and she was discharged on day 7 without complications. At the 6-month follow-up, there had been no untoward events, and there was marked improvement in her functional status. TAVI for symptomatic aortic valve stenosis is a less invasive, alternative approach for high-risk patients.