Masaki Miyasaka1, Norio Tada2, Masataka Taguri3, Shigeaki Kato4, Yusuke Enta2, Tatsushi Otomo2, Masaki Hata2, Yusuke Watanabe5, Toru Naganuma6, Motoharu Araki7, Futoshi Yamanaka8, Shinichi Shirai9, Hiroshi Ueno10, Kazuki Mizutani11, Minoru Tabata12, Akihiro Higashimori13, Kensuke Takagi14, Masanori Yamamoto15, Kentaro Hayashida16. 1. Cardiovascular Center, Sendai Kosei Hospital, Sendai, Japan. Electronic address: masaki108@gmail.com. 2. Cardiovascular Center, Sendai Kosei Hospital, Sendai, Japan. 3. Cardiovascular Center, Sendai Kosei Hospital, Sendai, Japan; Yokohama City University School of Medicine, Department of Biostatistics, Yokohama, Japan. 4. Cardiovascular Center, Sendai Kosei Hospital, Sendai, Japan; Center for Regional Cooperation Iwaki, Meisei University, Fukushima, Japan. 5. Division of Cardiology, Department of Internal Medicine, Teikyo University Hospital, Tokyo, Japan. 6. Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan. 7. Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan. 8. Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan. 9. Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan. 10. Department of Cardiovascular Medicine, Toyama University School of Medicine, Toyama, Japan. 11. Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. 12. Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan. 13. Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan. 14. Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan. 15. Division of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan; Department of Cardiology, Nagoya Heart Canter, Nagoya, Japan. 16. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
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.
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.
Authors: Paul T L Chiam; Kentaro Hayashida; Yusuke Watanabe; Wei-Hsian Yin; Hsien-Li Kao; Michael K Y Lee; Fabio Enrique Posas; Mann Chandavimol; Wacin Buddhari; Timothy C Dy; Ngoc Quang Nguyen; Won Jang Kim; Kiyuk Chang; Mao-Shin Lin; Yat-Yin Lam; Hung Manh Pham; Shaiful Azmi Yahaya; Kay Woon Ho; Wenzhi Pan; Xian-Bao Liu; Jian'an Wang; Hyo Soo Kim; Mao Chen Journal: Open Heart Date: 2021-01
Authors: Pier Pasquale Leone; Fabio Fazzari; Francesco Cannata; Jorge Sanz-Sanchez; Antonio Mangieri; Lorenzo Monti; Ottavia Cozzi; Giulio Giuseppe Stefanini; Renato Bragato; Antonio Colombo; Bernhard Reimers; Damiano Regazzoli Journal: Front Cardiovasc Med Date: 2021-06-04