Impact of Balloon Postdilation on Six-Year Mortality After Transcatheter Aortic Valve Replacement

Akira Shimokawa, Kenji Yoshitani, Hisanori Hayashi, Takashi Kakuta, Naonori Kawamoto, Hideaki Kanzaki, Satsuki Fukushima, Tomoyuki Fujita, Soshiro Ogata, Yoshihiko Ohnishi

Research output: Contribution to journalArticlepeer-review


Objectives: Balloon postdilation (BPD) is one strategy for decreasing paravalvular leakage, but its effect on long-term mortality remains unclear. The authors sought to clarify whether BPD influences long-term mortality of patients with transcatheter aortic valve replacement (TAVR). Design: Single-center retrospective study. Setting: National heart center; single institution. Participants: Participants were patients who underwent TAVR in the authors’ hospital from January 2014 to December 2016. A balloon-expandable Sapien XT or Sapien3, or self-expandable CoreValve or Evolute R, was implanted according to the decision of the surgeon considering degree of calcification of the aortic valve. Interventions: No interventions. Measurements and Main Results: Multivariate Cox regression analysis and inverse probability weighted estimation were performed using a propensity score to examine whether BPD influenced six-year mortality. Ultimately, 180 patients were analyzed. During the follow-up period, with a median of 1104 (interquartile range: 730-1463) days, 41 patients died and cumulative incidence of mortality at six years was 22.8%. Society of Thoracic Surgeons score (odds ratio [OR]: 2.257, 95% CI: 1.213-4.197, p = 0.010)], BPD (OR: 0.306, 95% CI: 0.098-0.953, p = 0.041), and paravalvular regurgitation of at least moderate-to-mild severity after deploying (OR: 5.407, 95% CI: 1.626-17.978, p = 0.006) were significant factors of mortality. Conclusions: BPD is associated with reduced six-year mortality.

Original languageEnglish
Pages (from-to)2626-2630
Number of pages5
JournalJournal of Cardiothoracic and Vascular Anesthesia
Issue number9
Publication statusPublished - 09-2021

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine


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