TY - JOUR
T1 - Transcatheter Aortic Valve Implantation in Japanese Patients With Large Annulus
T2 - The OCEAN-TAVI Registry
AU - Onishi, Kyohei
AU - Mizutani, Kazuki
AU - Fujita, Kosuke
AU - Ueno, Masafumi
AU - Sakaguchi, Genichi
AU - Nakazawa, Gaku
AU - Ohno, Yohei
AU - Yashima, Fumiaki
AU - Naganuma, Toru
AU - Tada, Norio
AU - Shirai, Shinichi
AU - Yamanaka, Futoshi
AU - Noguchi, Masahiko
AU - Izumo, Masaki
AU - Takagi, Kensuke
AU - Asami, Masahiko
AU - Ueno, Hiroshi
AU - Nishina, Hidetaka
AU - Otsuka, Toshiaki
AU - Watanabe, Yusuke
AU - Yamamoto, Masanori
AU - Hayashida, Kentaro
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/9
Y1 - 2024/9
N2 - Background: East Asians have smaller aortic valve complexes than individuals from Western countries, and few studies have reported transcatheter aortic valve implantation (TAVI) outcomes in Asian patients with a large annulus. Objectives: This study aimed to compare the short- and long-term outcomes of TAVI using balloon-expandable valves (BEVs) and self-expandable valves (SEVs) in Asian patients with a large annulus. Methods: The study retrospectively analyzed the data from the OCEAN-TAVI (Optimized Transcatheter Valvular Intervention Transcatheter Aortic Valve Implantation) registry. A large annulus was defined by an annular area ≥500 mm2 and an average diameter ≥25 mm as measured by computed tomography. The primary endpoint was 3-year all-cause mortality. Secondary endpoints were 3-year heart failure rehospitalization (HFR) after TAVI, short-term outcomes of TAVI, and changes in valve function 2 years after TAVI. Results: Among 773 patients, 671 underwent BEV TAVI. The SEV TAVI group showed a significantly higher incidence of greater than moderate paravalvular leakage (PVL) (P < 0.001), and an increased pacemaker implantation rate (P = 0.035). The incidence of prosthesis-patient mismatch did not differ between the 2 groups. The Kaplan-Meier curve showed no significant differences in 3-year all-cause mortality and HFR rates (log-rank P = 0.900), and echocardiographic valve function at 2 years post-TAVI did not differ between the 2 groups. Conclusions: The lack of differences in postoperative valve performance and long-term prognosis between BEV TAVI and SEV TAVI highlights the importance of selecting valves that can reduce the pacemaker implantation rate and PVL grade in the acute phase in patients with a large annulus.
AB - Background: East Asians have smaller aortic valve complexes than individuals from Western countries, and few studies have reported transcatheter aortic valve implantation (TAVI) outcomes in Asian patients with a large annulus. Objectives: This study aimed to compare the short- and long-term outcomes of TAVI using balloon-expandable valves (BEVs) and self-expandable valves (SEVs) in Asian patients with a large annulus. Methods: The study retrospectively analyzed the data from the OCEAN-TAVI (Optimized Transcatheter Valvular Intervention Transcatheter Aortic Valve Implantation) registry. A large annulus was defined by an annular area ≥500 mm2 and an average diameter ≥25 mm as measured by computed tomography. The primary endpoint was 3-year all-cause mortality. Secondary endpoints were 3-year heart failure rehospitalization (HFR) after TAVI, short-term outcomes of TAVI, and changes in valve function 2 years after TAVI. Results: Among 773 patients, 671 underwent BEV TAVI. The SEV TAVI group showed a significantly higher incidence of greater than moderate paravalvular leakage (PVL) (P < 0.001), and an increased pacemaker implantation rate (P = 0.035). The incidence of prosthesis-patient mismatch did not differ between the 2 groups. The Kaplan-Meier curve showed no significant differences in 3-year all-cause mortality and HFR rates (log-rank P = 0.900), and echocardiographic valve function at 2 years post-TAVI did not differ between the 2 groups. Conclusions: The lack of differences in postoperative valve performance and long-term prognosis between BEV TAVI and SEV TAVI highlights the importance of selecting valves that can reduce the pacemaker implantation rate and PVL grade in the acute phase in patients with a large annulus.
KW - aortic stenosis
KW - paravalvular leakage
KW - prosthesis-patient mismatch
KW - transcatheter aortic valve implantation
UR - http://www.scopus.com/inward/record.url?scp=85201499853&partnerID=8YFLogxK
U2 - 10.1016/j.jacasi.2024.07.002
DO - 10.1016/j.jacasi.2024.07.002
M3 - 学術論文
C2 - 39371621
AN - SCOPUS:85201499853
SN - 2772-3747
VL - 4
SP - 686
EP - 694
JO - JACC: Asia
JF - JACC: Asia
IS - 9
ER -