Author + information
- Received November 24, 2017
- Revision received January 25, 2018
- Accepted January 30, 2018
- Published online April 16, 2018.
- Masaki Miyasaka, MDa,∗ (, )
- Norio Tada, MDa,
- Masataka Taguri, PhDa,b,
- Shigeaki Kato, PhDa,c,
- Yusuke Enta, MDa,
- Tatsushi Otomo, MDa,
- Masaki Hata, MDa,
- Yusuke Watanabe, MDd,
- Toru Naganuma, MDe,
- Motoharu Araki, MDf,
- Futoshi Yamanaka, MDg,
- Shinichi Shirai, MDh,
- Hiroshi Ueno, MDi,
- Kazuki Mizutani, MDj,
- Minoru Tabata, MDk,
- Akihiro Higashimori, MDl,
- Kensuke Takagi, MDm,
- Masanori Yamamoto, MD, PhDn,o,
- Kentaro Hayashida, MD, PhDp,
- on behalf of the OCEAN-TAVI Investigators
- aCardiovascular Center, Sendai Kosei Hospital, Sendai, Japan
- bYokohama City University School of Medicine, Department of Biostatistics, Yokohama, Japan
- cCenter for Regional Cooperation Iwaki, Meisei University, Fukushima, Japan
- dDivision of Cardiology, Department of Internal Medicine, Teikyo University Hospital, Tokyo, Japan
- eInterventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan
- fDepartment of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
- gDepartment of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
- hDepartment of Cardiology, Kokura Memorial Hospital, Kokura, Japan
- iDepartment of Cardiovascular Medicine, Toyama University School of Medicine, Toyama, Japan
- jDepartment of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
- kDepartment of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan
- lDepartment of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan
- mDepartment of Cardiology, Ogaki Municipal Hospital, Gifu, Japan
- nDivision of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan
- oDepartment of Cardiology, Nagoya Heart Canter, Nagoya, Japan
- pDepartment of Cardiology, Keio University School of Medicine, Tokyo, Japan
- ↵∗Address for correspondence:
Dr. Masaki Miyasaka, Cardiovascular Center, Sendai Kousei Hospital, 4-15 Hirosemachi Aoba, Sendai, Miyagi 980-0873, Japan.
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.
Drs. Tada, Araki, Shirai, and Hayashida are clinical proctors for Edwards Lifesciences. Drs. Watanabe, Naganuma, Tabata, Takagi, and Yamamoto are clinical proctors for Edwards Lifesciences and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 24, 2017.
- Revision received January 25, 2018.
- Accepted January 30, 2018.
- 2018 American College of Cardiology Foundation