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TAVI

TAVI was applied clinically for the first time in the world in 2002, and in October 2009 we implemented TAVI for the first time in Japan. Since then, our facility has participated in trials of all TAVI valves, and employed the most advanced medical care to provide the same treatment for chronic dialysis patients and others.
Since being approved for insurance coverage in 2013, TAVI has been actively employed for patients with a high risk indicated for open-heart surgery, and since 2014 the number of cases has been about 100 per year. With the cumulative number of cases exceeding 420 at the end of 2016, our institution boasts the largest number in Japan. Including those currently undergoing clinical trials, there are now four types of TAVI valve available, and one characteristic of our facility is the ability to select from a range of options the most suitable valve for each patient.

TAVI: Transcatheter Aortic Valve Implantation, Minimally-Invasive Surgery for Aortic Valve Stenosis

When TAVI is used

Selection criteria:

  • in cases of severe aortic stenosis diagnosed with echocardiography
  • in cases where the Heart Team judges the patient to be high-risk for open-heart surgery due to age or complications, or in cases where open-heart surgery is impossible

Exclusion criteria:

  • non-cardiac comorbidities with a prognosis of less than 12 months
  • marked decrease in ability to perform ADLs, with no expectation of recovery
  • severe dementia (inability to consent)

TAVI valves available at our institution

Edwards SAPIEN 3
(balloon expansion)
CoreValve Evolut R
(self-expanding)
Portico
(national clinical trials)
Acurate neo TF
(national clinical trials)

TAVI at our hospital:

  1. Most experienced institution in Japan (over 700 cases to date)
  2. Excellent clinical performance
    -30 day survival rate: 99.0%
    -home discharge rate: 95%, average post-operative hospital stay: 11 days
  3. Participating in all national clinical trials (TAVI also available for chronic dialysis patients)
  4. Three TAVI Supervisor physicians
  5. Two members of staff with study-abroad experience in Germany

The first use of TAVI in Japan (October 2009)

The first use of TAVI in Japan (October 2009)

TAVI in our Department

TAVI in Japan

Our department is involved in all TAVI trials

TAVI cases: 453

Regarding TAVI, 30 day mortality is 0.80%, which is no worse than open heart surgery (subjects with average age of 82.7 years, STS score of 10.1%). There have been no surgical death cases since 2015, and the home discharge rate is around 90%, which leads us to consider this a treatment that can maintain the patient's quality of life.

Home discharge rate and post-operative hospitalization period

These good results are all thanks to the staff of this facility, and their abundant experience in medical treatment. We have three certified TAVI supervisors, and two staff members who have trained with state-of-the-art TAVI valve therapy in Germany.
In the future, minimally-invasive treatment using a catheter is expected to contribute not only for the aortic valve but also in other heart valves in the future. We will continue to provide patients with high-quality medical treatment, supporting society with state-of-the-art medical technology to ensure patients' safety and peace of mind . Click here for more details on TAVI

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