Five-Year Transcatheter Aortic Valve Replacement Outcomes in Chronic Hemodialysis vs. Non-Hemodialysis Patients Using Balloon-Expandable Devices

  • Mizote Isamu
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Nakamura Daisuke
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Maeda Koichi
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Dohi Tomoharu
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Shimamura Kazuo
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Kawamura Ai
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Yamashita Kizuku
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Matsuhiro Yutaka
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Kosugi Shumpei
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Sugae Hiroki
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Takeda Yasuharu
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Sakata Yasushi
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine

抄録

<p>Background: Based on the results of a clinical trial in Japan, transcatheter aortic valve replacement (TAVR) for hemodialysis (HD) patients gained approval; however, mid-term TAVR outcomes and transcatheter aortic valve (TAV) durability in HD patients remain unexplored.</p><p>Methods and Results: We analyzed background, procedural, in-hospital outcome, and follow-up data for 101 HD patients and 494 non-HD patients who underwent TAVR using balloon-expandable valves (SAPIEN XT or SAPIEN 3) retrieved from Osaka University Hospital TAVR database. Periprocedural mortality and TAVR-related complications were comparable between HD and non-HD patients. However, Kaplan-Meier analysis revealed that HD patients had significantly lower survival rates (log-rank test, P<0.001). In addition, HD patients had significantly higher rates of severe structural valve deterioration (SVD) than non-HD patients (Gray test, P=0.038).</p><p>Conclusions: TAVR in HD patients had comparable periprocedural mortality but inferior mid-term survival and TAV durability than in non-HD patients. Indications for TAVR in younger HD patients should be carefully determined, considering the possibility of a TAV-in-TAV procedure when early SVD occurs.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal advpub (0), 2024-05-11

    一般社団法人 日本循環器学会

詳細情報 詳細情報について

  • CRID
    1390018672471704192
  • DOI
    10.1253/circj.cj-24-0050
  • ISSN
    13474820
    13469843
  • PubMed
    38735703
  • 本文言語コード
    en
  • データソース種別
    • JaLC
    • PubMed
  • 抄録ライセンスフラグ
    使用不可

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