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Early Safety and Efficacy of Transcatheter Aortic Valve Implantation for Asian Nonagenarians (from KMH Registry)
- Source :
- International Heart Journal. 58:900-907
- Publication Year :
- 2017
- Publisher :
- International Heart Journal (Japanese Heart Journal), 2017.
-
Abstract
- As Japan has one of the most rapidly aging populations in the world, transcatheter aortic valve implantation (TAVI) is likely to be performed in increasing numbers of older people. There is little information on either the efficacy or the safety of TAVI in nonagenarians in Asia.From October 2013 to June 2015, 112 consecutive patients underwent TAVI with Edwards SAPIEN XT valves in our institution. We compared 25 patients aged at least 90 years (mean 91.6 ± 1.7 years) with 87 patients aged under 90 years (mean 82.5 ± 6.0 years) at the time of TAVI. All definitions of clinical endpoints and adverse events were based on the Valve Academic Research Consortium 2 definitions.The median follow-up interval was 561.5 days (the first and third quarters, 405.0 and 735.8 days). Nonagenarians had a higher logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), Euro II score, and the Society of Thoracic Surgeons predictive risk of mortality (STS) score, and a prevalence of clinical frailty scale ≥ 4. The rate of device success, and the 30-day and 6-month mortalities were not different between patients aged ≥ 90 years and < 90 years (96.0% versus 92.0%, P = 0.68; both 0%, P = 1.00; 4.0% versus 3.5%, P = 0.32, respectively). At six months, clinical efficacy and time-related valve safety were also similar in the two groups (12.5% versus 13.4%, P = 1.00; 4.5% versus 10.3%, P = 0.68, respectively). The cumulative 1-year mortalities were not significantly different between the two groups (8.4% versus 9.4%, P = 0.94, respectively).TAVI can contribute to acceptable clinical results and benefits in a carefully selected group of nonagenarians in Asia.
- Subjects :
- Male
medicine.medical_specialty
Transcatheter aortic
030204 cardiovascular system & hematology
Transcatheter Aortic Valve Replacement
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Japan
Internal medicine
medicine
Clinical endpoint
Risk of mortality
Humans
Registries
030212 general & internal medicine
Clinical efficacy
Adverse effect
Aged
Aged, 80 and over
business.industry
EuroSCORE
Aortic Valve Stenosis
General Medicine
Surgery
Cardiology
Female
Operative risk
Cardiology and Cardiovascular Medicine
business
Edwards sapien
Subjects
Details
- ISSN :
- 13493299 and 13492365
- Volume :
- 58
- Database :
- OpenAIRE
- Journal :
- International Heart Journal
- Accession number :
- edsair.doi.dedup.....e10bb576aee5db712d4163908e8e7d27