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2015 ; 21
(2
): 132-8
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English Wikipedia
Characteristics of inoperable patients with severe aortic valve stenosis -in the
era of transcatheter aortic valve replacement
#MMPMID25078548
Seki T
; Sakakibara M
; Shingu Y
; Katoh H
; Wakasa S
; Tsutsui H
; Matsui Y
Ann Thorac Cardiovasc Surg
2015[]; 21
(2
): 132-8
PMID25078548
show ga
PURPOSE: Transcatheter aortic valve replacement (TAVR) has emerged as a
therapeutic option for severe aortic valvular stenosis (AS). To determine the
indication for TAVR, it is mandatory to clarify the characteristics of the
patients who were judged as inoperable for conventional aortic valve replacement
(cAVR). METHODS: Of 185 patients newly diagnosed as severe AS from March 2010 to
April 2011, we studied the characteristics of 61 (33%) patients (mean age, 86 ± 8
years) who were judged as inoperable. RESULTS: Younger patients (<85 years old, n
= 22) had more major comorbidities and lower left ventricular ejection fraction
than older patients (?85 years old, n = 39). Mean estimated mortality for cAVR by
Japan score was 7.0% ± 7.4%. Japan score did not correlate to age and was
calculated relatively low in the older age group (6.2% ± 7.0%) than the younger
age group (8.3% ± 8.1%). CONCLUSION: One thirds of severe AS patients were judged
as inoperable. In advanced age patients, age itself and other factors, which are
not included in the conventional scoring systems, might have contributed to the
decision making not to perform cAVR by cardiologists. Further study is necessary
to define risk factors except for age.