title: Transcatheter aortic valve implantation in patients of small body size.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy and safety of transcatheter aortic valve implantation (TAVI) in patients of small body size (SB).
  
  
  RESULTS
  Between October 2006 and November 2011, 424 patients undergoing TAVI were evaluated. Patients with a small body surface area (BSA; <1.75 m(2)) were defined as the "SB group" (n = 215) and the remaining large BSA patients as the "LB group" (n = 209). In the SB group, mean annulus diameter measured by CT and minimal femoral artery diameter were significantly smaller (23.1 ± 1.92 vs. 24.3 ± 1.91 mm, P < 0.01; 7.59 ± 1.06 vs. 8.29 ± 1.34 mm, P < 0.01, respectively). The logistic EuroSCORE was similar between groups (22.5 ± 10.4 vs. 23.4 ± 12.0; P = 0.43). Equivalent device success (91.2% vs. 91.4%; P = 0.94) and 30-day survival rates (85.1% vs. 87.6%; P = 0.46) were achieved in both groups. Vascular complications and the 30-day combined safety end point rate were significantly higher in the SB group (13.0% vs. 4.3%, P < 0.01; 27.4% vs. 18.3%, P = 0.03, respectively). Similar post-procedural mean pressure gradient was achieved in both groups (10.2 ± 4.3 vs. 11.0 ± 4.6 mmHg; P = 0.12). Multivariate analysis showed that BSA was one of the independent predictors of 30-day combined safety end point (Odds ratio: 0.20; 95% confidence interval (CI): 0.05-0.88; P = 0.03). However, Kaplan-Meier analysis revealed no significant difference in mid-term survival rate between groups (log-rank P = 0.64).
  
  
  CONCLUSIONS
  TAVI in SB patients resulted in similar clinical outcomes with effective post-procedural hemodynamics compared with LB patients. Care should be taken to avoid vascular complications in SB patients.
authors.affiliation: Institut Cardiovasculaire Paris Sud, 6 Avenue du Noyer Lambert, 91300, Massy, France.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashida
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.forename: Thomas
authors.initials: T
authors.lastname: Hovasse
authors.forename: Mauro
authors.initials: M
authors.lastname: Romano
authors.forename: Philippe
authors.initials: P
authors.lastname: Garot
authors.forename: Arnaud
authors.initials: A
authors.lastname: Farge
authors.forename: Patrick
authors.initials: P
authors.lastname: Donzeau-Gouge
authors.forename: Erik
authors.initials: E
authors.lastname: Bouvier
authors.forename: Bertrand
authors.initials: B
authors.lastname: Cormier
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Morice
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015992:Body Mass Index; D049628:Body Size; D001830:Body Surface Area; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011474:Prosthesis Design; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: aortic valve; small body size; transcatheter aortic valve implantation; vascular complication