Transcatheter aortic valve implantation: Implications for Asian patients

摘要

Background: transcatheter aortic valve implantation is now an accepted therapy for patients with severe aortic valve stenosis who are deemed inoperable, and it is a reasonable alternative for patients with high surgical risk. This study assessed the clinical outcomes of this procedure and the implications of transcatheter aortic valve implantation for such patients. Methods: 14 consecutive patients with severe aortic valve stenosis, who underwent transcatheter aortic valve implantation, were assessed. Baseline clinical characteristics, procedural information, and clinical outcomes and complications were compared at baseline and at follow-up. Thirty-day mortality was also assessed. Results: the mean age of the patients was 81±8 years (35% females). The mean Society of Thoracic Surgeons score was 6.8±3.7. Most patients had chronic kidney disease with an estimated glomerular filtration rate of 44.5±14.9 mL.kg-1?min-1. The mean annulus diameter was 21.9±1.7 mm, and 8 (57%) patients received 23-mm valves. After transcatheter aortic valve implantation, the mean transaortic gradient and aortic valve area improved from 42.9±19.4 to 8.9±3.1mm Hg (p0.001) and 0.7±0.1 to 1.5±0.3 cm2 (p0.001), respectively. The 30-day mortality for this cohort was 7%. Conclusion: transcatheter aortic valve implantation can be performed successfully in carefully selected Asian patients. The decision to undertake this procedure should be guided by the surgical team.