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JACC Cardiovasc Interv. 2018 Apr 23;11(8):771-780. doi: 10.1016/j.jcin.2018.01.273.

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

Author information

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.

KEYWORDS:

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

PMID:
29673509
DOI:
10.1016/j.jcin.2018.01.273
[Indexed for MEDLINE]
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