著者
Yasuaki Takeji Tomohiko Taniguchi Takeshi Morimoto Naritatsu Saito Kenji Ando Shinichi Shirai Genichi Sakaguchi Yoshio Arai Yasushi Fuku Yuichi Kawase Tatsuhiko Komiya Natsuhiko Ehara Takeshi Kitai Tadaaki Koyama Shin Watanabe Hirotoshi Watanabe Hiroki Shiomi Eri Minamino-Muta Shintaro Matsuda Hidenori Yaku Yusuke Yoshikawa Kazuhiro Yamazaki Masahide Kawatou Kazuhisa Sakamoto Toshihiro Tamura Makoto Miyake Hisashi Sakaguchi Koichiro Murata Masanao Nakai Norio Kanamori Chisato Izumi Hirokazu Mitsuoka Masashi Kato Yutaka Hirano Tsukasa Inada Kazuya Nagao Hiroshi Mabuchi Yasuyo Takeuchi Keiichiro Yamane Takashi Tamura Mamoru Toyofuku Mitsuru Ishii Moriaki Inoko Tomoyuki Ikeda Katsuhisa Ishii Kozo Hotta Toshikazu Jinnai Nobuya Higashitani Yoshihiro Kato Yasutaka Inuzuka Yuko Morikami Kenji Minatoya Takeshi Kimura on befalf of the CURRENT AS Registry Investigators and K-TAVI Registry Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-19-0951, (Released:2020-02-01)
参考文献数
35
被引用文献数
12

Background:There are no data comparing transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) outcomes in real clinical practice in Japan.Methods and Results:We combined 2 independent registries, the K-TAVI Registry (a 6-center prospective registry of consecutive patients who underwent TAVI) and the CURRENT AS Registry (a large, 27-center registry of 3,815 consecutive patients with severe aortic stenosis [AS]). In the K-TAVI Registry, 338 patients underwent TAVI with SAPIEN XT balloon-expandable valves from October 2013 to January 2016, whereas in the CURRENT AS Registry 237 patients with severe AS underwent SAVR from January 2003 to December 2011. Propensity score matching was conducted, with final cohort comprising 306 patients. The cumulative 2-year incidence of all-cause death and heart failure (HF) hospitalization did not differ significantly between the TAVI and SAVR groups (13.7% vs. 12.4% [P=0.81] and 7.9% vs 3.9% [P=0.13], respectively). After adjusting for residual confounders, there were no significant differences between the TAVI and SAVR groups in the risk for all-cause death (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.35–1.58; P=0.43) or HF hospitalization (HR 1.27; 95% CI 0.40–4.59; P=0.69).Conclusions:These findings from 2 independent Japanese registries suggest that the 2-year risk of all-cause mortality and HF does not differ significantly between TAVI and SAVR groups in real-world practice in Japan.
著者
Yasuo Tsuru Mizuki Miura Shinichi Shirai Masaomi Hayashi Kenji Taninobu Hiroshi Takiguchi Shinya Ito Mariko Yano Tomohiro Kawaguchi Takashi Morinaga Akihiro Isotani Shinichi Kakumoto Katsuhiro Seo Yoshio Arai Genichi Sakaguchi Kenji Ando
出版者
International Heart Journal Association
雑誌
International Heart Journal (ISSN:13492365)
巻号頁・発行日
pp.18-484, (Released:2019-04-25)
参考文献数
18
被引用文献数
3

Aortic complex rupture is one of the most critical complications associated with transcatheter aortic valve implantation (TAVI). Its incidence is rare, and its mechanism varies by case; therefore, it is difficult to identify the predictors of complex rupture. Herein, we report a clinical case series of aortic complex rupture. Within our cohort, the frequency of complex rupture was 0.8% (4/497 consecutive patients) with an in-hospital mortality of 0. Among these four patients with complex rupture, two underwent emergent thoracotomy and surgical hemostasis without a heart-lung machine and surgical aortic valve replacement, whereas the other two were conservatively managed. The case overview revealed the following similarities: all the patients were elderly, small women; balloon-expandable valves were used; the annulus area was small with heavily calcified leaflet; and aggressive treatment strategy was used (i.e., oversizing and post-dilatation). In such cases, TAVI should be performed with a careful strategy. Once aortic complex rupture occurs, damage can be minimized through cooperation with an institutional heart team and calm management.