Publications by authors named "Norio Tada"
Background: Transcatheter edge-to-edge mitral valve repair (M-TEER) using the MitraClip system is primarily performed using the transfemoral approach. However, when this approach is not feasible, the transjugular approach can be used as an alternative.
Case Summary: A 57-year-old man presented with heart failure and persistent New York Heart Association class IV symptoms, refractory to guideline-directed medical therapy, intravenous therapy, and intra-aortic balloon pumping.
Background: Balloon-assisted bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BA-BASILICA) enables valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) in patients at risk of coronary artery obstruction. However, its efficacy in patients with severely calcified leaflets remains unclear.
Case Summary: We report a 78-year-old woman with a deteriorated 21 mm Carpentier-Edwards PERIMOUNT Magna valve.
Background: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) is of greater concern in Asians, considering their relatively smaller annular sizes compared with Westerners. However, the prognostic significance of PPM in Asian populations has not been demonstrated.
Objectives: This study aimed to elucidate the prognostic value of PPM after TAVR in Asian patients.
Background: The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement.
Methods And Results: This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry.
Data concerning the clinical effect of the latest-generation self-expandable transcatheter heart valve (Evolut FX) remain limited. We aimed to assess the in-hospital outcomes of 3 bioprosthetic valves (Evolut EPO, PRO+, and FX). We analyzed data from a Japanese multicenter registry involving 634 consecutive patients who underwent transcatheter aortic valve replacement with Evolut FX up until October 2023.
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- East Asians typically have smaller aortic valve complexes compared to Western populations, and there’s limited data on TAVI outcomes in Asian patients with large annuli.
- This study analyzes TAVI results in Asian patients, comparing outcomes between balloon-expandable valves (BEVs) and self-expandable valves (SEVs) by examining data from the OCEAN-TAVI registry.
- Findings show no significant differences in 3-year all-cause mortality, heart failure rehospitalization rates, or valve function after 2 years between BEV and SEV groups, although SEVs had higher rates of paravalvular leakage and pacemaker implantation.
Difference in cardiac response after transcatheter aortic valve implantation according to flow and gradient pattern.
Eur Heart J Cardiovasc Imaging
December 2024
Article Synopsis
- The study analyzes the outcomes of 4,523 patients who underwent transcatheter aortic valve implantation (TAVI) for severe aortic stenosis, categorized into three groups based on flow gradient patterns: high-gradient AS (HG-AS), classical low-flow low-gradient AS (cLFLG-AS), and paradoxical low-flow low-gradient AS (pLFLG-AS).
- Results indicated that cLFLG-AS and pLFLG-AS had about 1.5 times higher two-year all-cause mortality rates compared to HG-AS, with cLFLG-AS showing more significant improvements in heart structure and function post-procedure.
- Specifically, cLFLG-AS patients experienced a greater reduction in left ventricular
Article Synopsis
- - The study explores outcomes of patients with mitral stenosis (MS) who underwent transcatheter aortic valve implantation (TAVI) alongside those with aortic stenosis (AS) but no MS, focusing on factors like mitral annulus calcification (MAC), transmitral gradient (TMG), and mitral valve area (MVA).
- - Findings showed that patients with MS were generally older, predominantly female, and had a higher surgical risk score compared to those without MS; however, their 30-day mortality rates were similar.
- - Over a median follow-up of 2.1 years, patients with MS had a significantly higher rate of adverse events than the control group, indicating that MS adversely affects clinical outcomes post
In response to the International Commission on Radiological Protection, which lowered the lens equivalent dose limit, Japan lowered the lens dose limit from 150 mSv yto 100 mSv/5 years and 50 mSv y, with this new rule taking effect on 1 April 2021. DOSIRISis a dosimeter that can accurately measure lens dose. Herein, we investigated lens dose in interventional cardiology physicians 1 year before and after the reduction of the lens dose limit using a neck dosimeter and lens dosimeter measurements.
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- * The analysis found no significant difference in all-cause death or heart failure rehospitalization rates between patients with small (23-mm) and larger SEVs (26 or 29-mm) during a median follow-up of 511 days.
- * The results suggest that small SEVs provide midterm clinical outcomes similar to larger SEVs, even in cases of postprocedural prosthesis-patient mismatch.
Article Synopsis
- The study evaluated the clinical outcomes and performance of the SAPIEN 3 Ultra RESILIA (S3UR) valve compared to the SAPIEN 3 (S3) valve in patients undergoing transcatheter aortic valve replacement (TAVR).
- Results showed no significant differences in in-hospital complications like death and vascular issues between the two groups, but the S3UR group had a lower incidence of paravalvular leakage and better pressure gradients.
- The findings suggest that while procedural complications are similar, the S3UR valve performs better, especially in smaller sizes, addressing some limitations of existing balloon-expandable valves.
Article Synopsis
- The study investigates the impact of pre-existing and new onset left bundle branch block (LBBB) on clinical outcomes in patients undergoing transcatheter aortic valve replacement (TAVR).
- Out of nearly 6,000 patients, 4.6% had pre-existing LBBB, while 27.6% developed new onset LBBB post-procedure.
- Results show that pre-existing LBBB was linked to significantly higher rates of all-cause and cardiovascular mortality compared to both the new onset LBBB and no LBBB groups, highlighting the need for careful monitoring of these patients.
Aims: A considerable proportion of candidates for transcatheter aortic valve implantation (TAVI) have underlying heart failure (HF) with preserved ejection fraction (HFpEF), which can be challenging for diagnosis because significant valvular heart disease should be excluded before diagnosing HFpEF. This study investigated the long-term prognostic value of the pre-procedural HFPEF score in patients with preserved ejection fraction (EF) undergoing TAVI.
Methods And Results: Patients who underwent TAVI between October 2013 and May 2017 were enrolled from the Optimized CathEter vAlvular iNtervention-Transcatheter Aortic Valve Implantation Japanese multicentre registry.
Article Synopsis
- Intradialytic hypotension (IDH) is a common issue during hemodialysis that can lead to serious heart problems, and it is often linked to aortic stenosis (AS).
- Transcatheter aortic valve replacement (TAVR) is a treatment for severe AS, and this study investigates whether it can help reduce episodes of IDH in hemodialysis patients.
- The study found that after undergoing TAVR, the rate of IDH dropped significantly from 43.2% to 10.3%, suggesting that treating severe AS with TAVR may effectively decrease IDH frequency in these patients.
Objectives: The clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) and concomitant active cancer remain insufficiently explored. This study aimed to assess the midterm outcomes of TAVR in patients diagnosed with AS and active cancer.
Methods: Data from the OCEAN-TAVI, a prospective Japanese registry of TAVR procedures, was analysed to compare prognoses and clinical outcomes in patients with and without active cancer at the time of TAVR.
Background: Individuals with heart failure displaying supra-normal left ventricular ejection fraction (snLVEF) may exhibit less favorable clinical outcomes in contrast to their counterparts with normal left ventricular ejection fraction (nLVEF). The distinctive characteristics and mid-term prognosis of individuals with severe aortic stenosis and snLVEF following transcatheter aortic valve replacement (TAVR) remain enigmatic.
Methods: Among 7393 patients diagnosed with severe aortic stenosis who underwent TAVR between 2013 and 2019 and were enlisted in the optimized transcatheter valvular intervention (OCEAN-TAVI) multicenter registry (UMIN000020423), we selected patients with left ventricular ejection fraction (LVEF) ≥ 50%.
Article Synopsis
- The NAPT trial aims to evaluate whether non-antithrombotic therapy is as effective as aspirin alone for patients who have undergone TAVI, especially since the best post-procedure antithrombotic treatment is still unclear.
- Conducted in Japan, the trial will involve 360 patients and will focus on key outcomes like mortality, heart attacks, strokes, and bleeding events.
- Findings will help clarify the risks and benefits of non-antithrombotic therapy, potentially improving care for high-risk TAVI patients.
Although interventional radiology (IVR) is preferred over surgical procedures because it is less invasive, it results in increased radiation exposure due to long fluoroscopy times and the need for frequent imaging. Nurses engaged in cardiac IVR receive the highest lens radiation doses among medical workers, after physicians. Hence, it is important to measure the lens exposure of IVR nurses accurately.
View Article and Find Full Text PDFElectrocardiogram (ECG) left ventricular hypertrophy (LVH) is associated with the prognosis of patients with aortic stenosis. However, the impact of the presence or absence of ECG-LVH on the clinical outcomes after transcatheter aortic valve implantation (TAVI) is limited. This study aimed to assess the prognostic value of ECG-LVH among patients with aortic stenosis treated by TAVI.
View Article and Find Full Text PDFPurpose: Our objective was to evaluate the feasibility of performing endovascular therapy (EVT) for aortoiliac artery disease using transradial approach (TRA) as compared to transfemoral approach (TFA).
Methods: We analyzed 9671 cases with symptomatic lower extremity artery disease due to aortoiliac occlusive disease (AIOD) treated using EVT from a Japanese Nationwide EVT Registry between January and December 2021. We compared the baseline characteristics, procedural information, and 30-day outcomes of patients who received EVT only via TRA (n=863 [16.