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Erschienen in: Heart and Vessels 10/2021

19.04.2021 | Original Article

Early and mid-term results of transcatheter aortic valve implantation and valve durability assessment

verfasst von: Masato Tochii, Shintaro Nakano, Chiho Tokunaga, Toshihisa Asakura, Atsushi Iguchi, Hiroyuki Nakajima, Akihiro Yoshitake

Erschienen in: Heart and Vessels | Ausgabe 10/2021

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Abstract

This study aimed to evaluate the early and mid-term outcomes of transcatheter aortic valve implantation (TAVI) and to assess valve durability. A total of 146 consecutive patients who underwent TAVI for severe aortic stenosis between October 2013 and August 2018 were retrospectively reviewed. All patients (mean age, 84 ± 6 years; age range 53–98 years; 42 males [28.7%]) had multiple comorbidities, with a mean logistic EuroSCORE of 30.9 ± 17.4%. Eighteen patients (12.3%) were aged 90 years or over. Five in-hospital deaths (3.4%) occurred, and 36 patients (24.7%) experienced major TAVI-related complications. With the transfemoral approach, 10 patients had major vascular complications, which mostly occurred with first-generation devices (n = 9) but less commonly with new-generation low-profile devices (P = 0.0078). During a follow-up period of 580 ± 450 (11–1738) days, 29 late deaths occurred. The survival rate was 86.0%, 78.0%, and 61.7% at 1, 2, and 3 years, respectively. Multivariate Cox hazard regression analysis revealed that more-than-moderate tricuspid regurgitation was the only independent risk factor for late deaths due to any cause (hazard ratio, 3.145; 95% confidence interval, 1.129–8.762; P = 0.0283). No statistically significant differences between post-TAVI before discharge from the hospital and at 4 years after TAVI were observed with respect to aortic valve area (1.76 ± 0.49 cm2 vs. 1.64 ± 0.38 cm2; P = 0.1871) and mean pressure gradient (10.0 ± 4.6 mmHg vs. 7.9 ± 3.3 mmHg; P = 0.5032). TAVI was a feasible method with acceptable early and mid-term outcomes and valve durability for at least 4 years in poor-risk patients. Further close follow-up is essential to evaluate late outcomes and valve durability.
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Metadaten
Titel
Early and mid-term results of transcatheter aortic valve implantation and valve durability assessment
verfasst von
Masato Tochii
Shintaro Nakano
Chiho Tokunaga
Toshihisa Asakura
Atsushi Iguchi
Hiroyuki Nakajima
Akihiro Yoshitake
Publikationsdatum
19.04.2021
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 10/2021
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-021-01842-x

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