title: Transcatheter aortic valve implantation: implications for Asian patients.
abstract: BACKGROUND
  transcatheter aortic valve implantation is now an accepted therapy for patients with severe aortic valve stenosis who are deemed inoperable, and it is a reasonable alternative for patients with high surgical risk. This study assessed the clinical outcomes of this procedure and the implications of transcatheter aortic valve implantation for such patients.
  
  
  METHODS
  14 consecutive patients with severe aortic valve stenosis, who underwent transcatheter aortic valve implantation, were assessed. Baseline clinical characteristics, procedural information, and clinical outcomes and complications were compared at baseline and at follow-up. Thirty-day mortality was also assessed.
  
  
  RESULTS
  the mean age of the patients was 81 ± 8 years (35% females). The mean Society of Thoracic Surgeons score was 6.8 ± 3.7. Most patients had chronic kidney disease with an estimated glomerular filtration rate of 44.5 ± 14.9 mL·kg(-1)·min(-1). The mean annulus diameter was 21.9 ± 1.7 mm, and 8 (57%) patients received 23-mm valves. After transcatheter aortic valve implantation, the mean transaortic gradient and aortic valve area improved from 42.9 ± 19.4 to 8.9 ± 3.1 mm Hg (p < 0.001) and 0.7 ± 0.1 to 1.5 ± 0.3 cm(2) (p < 0.001), respectively. The 30-day mortality for this cohort was 7%.
  
  
  CONCLUSIONS
  transcatheter aortic valve implantation can be performed successfully in carefully selected Asian patients. The decision to undertake this procedure should be guided by the surgical team.
authors.affiliation: National University Heart Center, National University Hospital, Singapore.
authors.forename: Edgar Lw
authors.initials: EL
authors.lastname: Tay
authors.forename: James Wei-Luen
authors.initials: JW
authors.lastname: Yip
authors.forename: Kristine Lk
authors.initials: KL
authors.lastname: Teoh
authors.forename: Sophia
authors.initials: S
authors.lastname: Ang
authors.forename: Kian Keong
authors.initials: KK
authors.lastname: Poh
authors.forename: Lynette Ls
authors.initials: LL
authors.lastname: Teo
authors.forename: Tiong Cheng
authors.initials: TC
authors.lastname: Yeo
authors.forename: Chuen Neng
authors.initials: CN
authors.lastname: Lee
authors.forename: Huay Cheem
authors.initials: HC
authors.lastname: Tan
authors.forename: Jimmy Kf
authors.initials: JK
authors.lastname: Hon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D044466:Asian People; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000401:mortality; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D051436:Renal Insufficiency, Chronic / Q000208:ethnology / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Aortic valve; Asia; Southeastern; aortic valve stenosis; endovascular procedures; heart valve prosthesis implantation