First direct comparison of clinical outcomes between European and Asian cohorts in transcatheter aortic valve implantation: The Massy study group vs. the PREVAIL JAPAN trial

Watanabe, Yusuke; Hayashida, Kentaro; Takayama, Morimasa; Mitsudo, Kazuaki; Nanto, Shinsuke; Takanashi, Shuichiro; Komiya, Tatsuhiko; Kuratani, Toru; Tobaru, Tetsuya; Goto, Tsuyoshi; Lefèvre, Thierry; Sawa, Yoshiki; Morice, Marie Claude

doi:10.1016/j.jjcc.2014.05.001

Cited by 59 publications

(42 citation statements)

References 32 publications

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“…more vascular complications). (9) Secondly, a Japanese study found that their patients had smaller annulus dimensions on multidetector CT as compared with their European counterparts, (10) with implications for prosthesis-patient interactions. We also hypothesised that other factors, such as smaller left ventricular cavity size and increased frailty in Asian populations, may affect the clinical outcomes of TAVI.…”

Section: Discussionmentioning

confidence: 99%

Mid-term study of transcatheter aortic valve implantation in an Asian population with severe aortic stenosis: two-year Valve Academic Research Consortium-2 outcomes

Chew¹,

Hon²,

Yip³

et al. 2017

smedj

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INTRODUCTION Transcatheter aortic valve implantation (TAVI) is an effective treatment for high-risk or inoperativepatients with severe aortic stenosis. Given the unique characteristics of Asian populations, questions regarding mid-term outcomes in Asians undergoing TAVI have yet to be addressed. We evaluated the two-year clinical outcomes of TAVI in an Asian population using Valve Academic Research Consortium-2 definitions.METHODS This prospective study recruited 59 patients from a major academic medical centre in Singapore. The main outcomes were two-year survival rates, peri-procedural complications, symptom improvement, valvular function and assessment of learning curve. RESULTSMean age was 76.8 years (61.0% male), mean body surface area 1.6 m 2 and mean logistic EuroSCORE 18.7%. Survival was 93.2%, 86.0% and 79.1% at 30 days, one year and two years, respectively. At 30 days post TAVI, the rate of stroke was 1.7%, life-threatening bleeding 5.1%, acute kidney injury 25.0%, major vascular complication 5.1%, and new permanent pacemaker implantation 6.8%. 29.3% of TAVI patients were rehospitalised (47.1% cardiovascular-related) within one year. These composite outcomes were measured: device success (93.2%); early safety (79.7%); clinical efficacy (66.1%); and time-related valve safety (84.7%). Univariate analysis found these predictors of two-year all-cause mortality: logistic EuroSCORE (hazard ratio [HR] 1.07; p < 0.001); baseline estimated glomerular filtration rate (HR 0.97; p = 0.048); and acute kidney injury (HR 5.33; p = 0.022). Multivariate analysis identified non-transfemoral TAVI as a predictor of cardiovascular-related two-year mortality (HR 14.64; p = 0.008).CONCLUSION Despite the unique clinical differences in Asian populations, this registry demonstrated favourable midterm clinical and safety outcomes in Asians undergoing TAVI.

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Section: Discussionmentioning

confidence: 99%

Mid-term study of transcatheter aortic valve implantation in an Asian population with severe aortic stenosis: two-year Valve Academic Research Consortium-2 outcomes

Chew¹,

Hon²,

Yip³

et al. 2017

smedj

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show abstract

“…These include female sex, lower body surface area, and smoking history. Secondly, Asian populations generally have a smaller aortic valve annulus (19,20). In addition, Watanabe et al found that the sinus of Valsalva, sinus of Valsalva height, sinotubular junction, and sinotubular junction height were also smaller in Japanese patients when compared to Western patients, suggesting that these patients had a shallower sinus of Valsalva (19).…”

Section: Anatomymentioning

confidence: 99%

Transcatheter aortic valve implantation in Asia

Hon

Tay

2017

Ann. Cardiothorac. Surg.

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The use of transcatheter aortic valve implantation (TAVI) to treat severe symptomatic aortic valve stenosis has increased exponentially in the last decade. This rapid expansion was seen predominantly in Western developed nations and has been fuelled by favorable results reported from a plethora of well-publicized randomized controlled trials, large retrospective series and national registries. Now, TAVI has become the standard of care for inoperable patients and an alternative to open surgery in patients who are at intermediate to high risk for open surgery. Notwithstanding these positive results, Asia has been relatively slow to adopt this technology despite a potentially large patient pool. Unique features of Asian medical environments and differences in Asian anatomy affecting TAVI uptake in Asia will be discussed. This article serves to outline the various challenging aspects of disseminating TAVI in Asian countries.

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“…First, a limited number of patients were included in this study. However, our registry included the largest number of Japanese patients undergoing TAVI in a real‐world setting compared with the limited indications inherent in previously reported clinical trials . Second, as preprocedural evaluation, such as MDCT or TEE, was performed separately in each individual study center, interobserver variability should be taken into account.…”

Section: Limitationsmentioning

confidence: 99%

Streamlining the learning process for TAVI: Insight from a comparative analysis of the OCEAN‐TAVI and the massy registries

Inohara

Hayashida

Watanabe

et al. 2015

Cathet Cardio Intervent

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First direct comparison of clinical outcomes between European and Asian cohorts in transcatheter aortic valve implantation: The Massy study group vs. the PREVAIL JAPAN trial

Abstract: Clinical outcomes after TAVI in the patients included in the PREVAIL JAPAN trial were acceptable and as safe as that of a single-center European cohort.

Cited by 59 publications

References 32 publications

Mid-term study of transcatheter aortic valve implantation in an Asian population with severe aortic stenosis: two-year Valve Academic Research Consortium-2 outcomes

Mid-term study of transcatheter aortic valve implantation in an Asian population with severe aortic stenosis: two-year Valve Academic Research Consortium-2 outcomes

Transcatheter aortic valve implantation in Asia

Streamlining the learning process for TAVI: Insight from a comparative analysis of the OCEAN‐TAVI and the massy registries

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