Five-Year Transcatheter Aortic Valve Replacement Outcomes in Chronic Hemodialysis vs. Non-Hemodialysis Patients Using Balloon-Expandable Devices
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- Mizote Isamu
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- Nakamura Daisuke
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- Maeda Koichi
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
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- Dohi Tomoharu
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- Shimamura Kazuo
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
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- Kawamura Ai
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
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- Yamashita Kizuku
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
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- Matsuhiro Yutaka
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- Kosugi Shumpei
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- Sugae Hiroki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- Takeda Yasuharu
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- 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
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- Circulation Journal
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Circulation Journal advpub (0), 2024-05-11
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