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Long-term outcomes of balloon-expandable transcatheter aortic valve replacement in Japanese patients

Published:October 18, 2022DOI:https://doi.org/10.1016/j.jjcc.2022.09.014

      Highlights

      • Data on long-term outcomes of transcatheter aortic valve replacement (TAVR) in Japanese patients beyond 5 years are limited.
      • The rate of freedom from all-cause death at 7 years was 35.8%.
      • The rates of structural valve deterioration (SVD) and bioprosthetic valve failure (BVF) at 7 years were 11.4% and 6.2%, respectively.
      • Although the mortality was high, the incidence of SVD and BVF was not rare.

      Abstract

      Background

      Data on long-term outcomes of transcatheter aortic valve replacement (TAVR) in Japanese patients beyond 5 years are limited.

      Methods

      Between June 2010 and December 2014, 55 consecutive inoperable or high surgical risk patients underwent TAVR with SAPIEN XT valves (Edwards Lifesciences, Irvine, CA, USA) for severe aortic stenosis at our institution. Among them, 2 patients were excluded from the analysis because one was converted to open surgery during the TAVR procedure and the other could not undergo TAVR due to device delivery failure. We retrospectively analyzed long-term clinical outcomes of these 53 patients (mean age: 84.1 years; mean STS score: 8.4) who had at least a 7-year follow-up after TAVR.

      Results

      The rates of freedom from all-cause and cardiovascular deaths at 7 years were 35.8 % and 79.3 %, respectively. The moderate or severe structural valve deterioration (SVD) rate at 5 and 7 years was 7.2 % and 11.4 %, respectively. The rate of bioprosthetic valve failure (BVF) at 7 years was 6.2 %.

      Conclusions

      The 7-year mortality rate of inoperable or high surgical risk patients treated with SAPIEN XT was high, while the cardiovascular mortality rate was acceptable. Although the poor survival rate limited the long-term assessment of SAPIEN XT valve durability, the incidence of SVD and BVF was not rare.

      Graphical abstract

      Keywords

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