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Erschienen in: Cardiovascular Intervention and Therapeutics 4/2019

13.02.2019 | Original Article

The role of transcatheter aortic valve replacement in the patients with severe aortic stenosis requiring major non-cardiac surgery

verfasst von: Taishi Okuno, Kazuyuki Yahagi, Yu Horiuchi, Yu Sato, Tetsu Tanaka, Keita Koseki, Akira Osanai, Motoi Yokozuka, Sumio Miura, Kengo Tanabe

Erschienen in: Cardiovascular Intervention and Therapeutics | Ausgabe 4/2019

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Abstract

Severe aortic stenosis (AS) is considered as an independent risk factor for perioperative cardiac complications of non-cardiac surgery. Surgical aortic valve replacement should be considered before non-cardiac surgery in patients with symptomatic severe AS. However, recently, transcatheter aortic valve replacement (TAVR) has emerged as an alternative approach for selected AS patients. We sought to determine the safety and efficacy of TAVR in preparation for major non-cardiac surgery. From our retrospective database, seven patients who underwent TAVR in preparation for major non-cardiac surgery were identified, and their clinical and hemodynamic data were collected. After TAVR, a significant reduction in the mean transaortic pressure gradient from 54.0 (Interquartile range (IQR) 47.5–64.5) to 18.0 (IQR 12.5–19.0) mmHg (p = 0.016) and an increase in the calculated aortic valve area from 0.6 (IQR 0.6–0.7) to 1.3 (IQR 1.1–1.5) cm2 (p = 0.022) were noted. Non-cardiac surgery included lung segmentectomy and lymph node dissection, lung lobectomy, ileocecal resection, partial colectomy, partial nephrectomy, nephroureterectomy, laparoscopic nephrectomy, and laparoscopic nephroureterectomy. All the initial non-cardiac surgeries were performed without cardiac complications, under general anesthesia, 37 (IQR 32–74) days after TAVR. Two of the patients eventually needed additional non-cardiac surgery, which was performed uneventfully without the need for additional AS treatment. TAVR was an effective and safe procedure that might reduce the risk of general anesthesia and major non-cardiac surgery in severe AS.
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Metadaten
Titel
The role of transcatheter aortic valve replacement in the patients with severe aortic stenosis requiring major non-cardiac surgery
verfasst von
Taishi Okuno
Kazuyuki Yahagi
Yu Horiuchi
Yu Sato
Tetsu Tanaka
Keita Koseki
Akira Osanai
Motoi Yokozuka
Sumio Miura
Kengo Tanabe
Publikationsdatum
13.02.2019
Verlag
Springer Japan
Erschienen in
Cardiovascular Intervention and Therapeutics / Ausgabe 4/2019
Print ISSN: 1868-4300
Elektronische ISSN: 1868-4297
DOI
https://doi.org/10.1007/s12928-019-00575-z

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