Fuku Yasushi, Goto Tsuyoshi, Komiya Tatsuhiko, Sakaguchi Genichi, Shimamoto Takeshi, Maruo Takeshi, Hasegawa Daiji, Otsuru Suguru, Saito Naoki, Hyodo Yusuke, Ueno Go, Kadota Kazushige, Mitsudo Kazuaki
Department of Cardiology, Kurashiki Central Hospital.
Circ J. 2014;78(6):1357-63. doi: 10.1253/circj.cj-13-1220. Epub 2014 Apr 3.
Few data exist on the results of transcatheter aortic valve implantation (TAVI) via the transfemoral approach in small slightly built Japanese patients with severe aortic stenosis who are ineligible or at high-risk for conventional surgical aortic valve replacement (SAVR). Therefore, the purpose was to investigate the early outcomes of TAVI using the transiliofemoral approach in Japan.
Between June 2010 and June 2013, 21 consecutive patients (mean age, 81.0 years; 81.0% female) underwent TAVI with Edwards SAPIEN XT valves using the transiliofemoral approach. The mean body surface area was 1.44±0.15m(2). The device success rate was 90.5%. Although 2 patients did not meet the echocardiographic criteria for device success, no failure to deliver and deploy a valve occurred. The mean effective aortic valve area increased from 0.54±0.12cm(2) at baseline to 1.46±0.29cm(2) after the procedure (P<0.001), and the mean aortic transvalvular pressure gradient decreased from 51.0±15.6 at baseline to 11.2±3.6 after the procedure (P<0.001). The 30-day mortality and combined safety endpoint rates were 0% and 4.8%, respectively. All patients achieved New York Heart Association functional class I or II at 30 days.
Early outcome of TAVI with the Edwards-SAPIEN XT valve via the transiliofemoral approach at Kurashiki Central Hospital is satisfactory for patients who are ineligible or at high risk for SAVR.
对于身材瘦小、患有严重主动脉瓣狭窄且不符合传统外科主动脉瓣置换术（SAVR）标准或手术风险高的日本患者，经股动脉途径进行经导管主动脉瓣植入术（TAVI）的相关数据较少。因此，本研究旨在探讨在日本采用经髂股动脉途径进行TAVI的早期疗效。
2010年6月至2013年6月期间，连续21例患者（平均年龄81.0岁；81.0%为女性）采用经髂股动脉途径，使用爱德华SAPIEN XT瓣膜进行TAVI。平均体表面积为1.44±0.15m²。器械成功率为90.5%。虽然有2例患者未达到器械成功的超声心动图标准，但未发生瓣膜输送和释放失败的情况。平均有效主动脉瓣面积从基线时的0.54±0.12cm²增加到术后的1.46±0.29cm²（P<0.001），平均主动脉跨瓣压差从基线时的51.0±15.6降至术后的11.2±3.6（P<0.001）。30天死亡率和综合安全终点发生率分别为0%和4.8%。所有患者在30天时均达到纽约心脏协会心功能I级或II级。
对于不符合SAVR标准或手术风险高的患者，仓敷中央医院采用经髂股动脉途径使用爱德华SAPIEN XT瓣膜进行TAVI的早期疗效令人满意。
