Background and Outcomes of TAVR in Low-Risk Score Patients
- VernacularTitle:低リスクスコアAS患者に対するTAVRの患者背景とアウトカム
- Author:
Kyoko SHIGETOMI
1
;
Joji ITO
1
;
Shinsuke KOTANI
1
;
Minoru TABATA
1
Author Information
- Keywords: aortic valve stenosis; transcatheter aortic valve replacement; transcatheter aortic valve implantation; low-risk
- From:Japanese Journal of Cardiovascular Surgery 2022;51(6):334-338
- CountryJapan
- Language:Japanese
- Abstract: Objective: This study aimed to examine the background and outcomes of transcatheter aortic valve replacement (TAVR) in patients with low-risk scores. Methods: We retrospectively reviewed 69 patients with risk scores of<4% undergoing TAVR in a single institution from January 2016 through June 2021. Results: The mean age of the patients was 81±4.5 years, and 52% of them were women. The reasons for TAVR selection included very old age (≥85 years; 20%); frailty (51%); ascending aortic calcification (4.3%); history of mediastinal radiation therapy (2.8%); and respiratory diseases (10%). Six patients required early discharge and recovery for another surgery following treatment of aortic stenosis or family members' care, and 2 patients had an estimated life expectancy of 1-5 years. Also, three patients strongly desired TAVR despite having none of the objective factors that favor TAVR. The median lengths of stay in the ICU and after TAVR were 1 day (1-11 days) and 5 days (3-40 days). There was neither operative mortality nor a need for aortic valve reintervention. Kaplan-Meier curves showed that the one-year survival rate was 99%, and two-year and three-year survival rates were 97% each. The causes of late death were sepsis, unknown factor, and intracranial hemorrhage. Discussion: The short-term and medium-term outcomes of TAVR with low-risk score patients were favorable although the patient background was poor due to high-risk factors for surgery that were excluded from the risk scores.
