Abstract
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 defne risk factors except for age.
| Original language | English |
|---|---|
| Pages (from-to) | 132-138 |
| Number of pages | 7 |
| Journal | Annals of Thoracic and Cardiovascular Surgery |
| Volume | 21 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jan 1 2015 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine
- Gastroenterology
Cite this
Characteristics of inoperable patients with severe aortic valve stenosis—in the era of transcatheter aortic valve replacement. / Seki, Tatsuya; Sakakibara, Mamoru; Shingu, Yasushige; Katoh, Hiroki; Wakasa, Satoru; Tsutsui, Hiroyuki; Matsui, Yoshiro.
In: Annals of Thoracic and Cardiovascular Surgery, Vol. 21, No. 2, 01.01.2015, p. 132-138.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Characteristics of inoperable patients with severe aortic valve stenosis—in the era of transcatheter aortic valve replacement
AU - Seki, Tatsuya
AU - Sakakibara, Mamoru
AU - Shingu, Yasushige
AU - Katoh, Hiroki
AU - Wakasa, Satoru
AU - Tsutsui, Hiroyuki
AU - Matsui, Yoshiro
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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 defne risk factors except for age.
AB - 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 defne risk factors except for age.
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UR - http://www.scopus.com/inward/citedby.url?scp=84928016220&partnerID=8YFLogxK
U2 - 10.5761/atcs.oa.14-00126
DO - 10.5761/atcs.oa.14-00126
M3 - Article
C2 - 25078548
AN - SCOPUS:84928016220
VL - 21
SP - 132
EP - 138
JO - Annals of Thoracic and Cardiovascular Surgery
JF - Annals of Thoracic and Cardiovascular Surgery
SN - 1341-1098
IS - 2
ER -