title: Early Outcomes in Japanese Dialysis Patients Treated With Transcatheter Aortic Valve Implantation.
abstract: BACKGROUND
  Although transcatheter aortic valve implantation (TAVI) is a new alternative treatment with acceptable midterm results for high surgical risk patients, at present performing the procedure in dialysis patients is not reimbursed in Japan.
  
  
  RESULTS
  The study group of 17 dialysis patients (mean age, 76.7±5.0 years) underwent TAVI with the SAPIEN/SAPIEN XT. EuroSCORE and STS score were 25.0±19.0% and 15.4±12.3%, respectively. Transiliofemoral and transapical approaches were performed in 7 (41.2%) and 10 patients (58.8%), respectively. ICU and hospital stays after TAVI were 1.8±1.6 and 12.9±12.7 days, respectively. Mean transvalvular gradients at discharge significantly decreased from 45.9±13.3 mmHg to 10.7±4.3 mmHg (P<0.0001) and effective orifice area significantly increased from 0.78±0.17 to 1.69±0.37 cm(2)(P<0.0001). Device success was 87.5%. One patient required a valve-in-valve procedure on 187-postoperative-day for an acute increase in paravalvular leakage caused by initial lower implantation of the device. The overall mortality at 1 year was 0% and clinical efficacies at 30 days, 6 months, and 1 year were 93.8%, 83.3%, and 69.2%, respectively.
  
  
  CONCLUSIONS
  Satisfactory early results were achieved with TAVI in Japanese dialysis patients with a high surgical risk, indicating it is a safe and effective alternative for the treatment of aortic valve stenosis in such patients.
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine.
authors.forename: Koichi
authors.initials: K
authors.lastname: Maeda
authors.forename: Toru
authors.initials: T
authors.lastname: Kuratani
authors.forename: Kei
authors.initials: K
authors.lastname: Torikai
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ichibori
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nakatani
authors.forename: Toshinari
authors.initials: T
authors.lastname: Onishi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakatani
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sakata
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ueno
authors.forename: Koichi
authors.initials: K
authors.lastname: Toda
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000628:therapy*; D044466:Asian People; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis; D065467:Transcatheter Aortic Valve Replacement