Predictors and Clinical Impact of Prosthesis-Patient Mismatch After Self-Expandable TAVR in Small Annuli.

JACC. Cardiovascular Interventions
Pier Pasquale LeoneTAVI-SMALL Investigators

Abstract

The aim of this study was to define predictors of prosthesis-patient mismatch (PPM) and its impact on mortality after transcatheter aortic valve replacement (TAVR) with self-expandable valves (SEVs) in patients with small annuli. TAVR seems to reduce the risk for PPM compared with surgical aortic valve replacement, especially in patients with small aortic annuli. Nevertheless, predictors and impact of PPM in this population have not been clarified yet. Predictors of PPM and all-cause mortality were investigated using multivariable logistic regression analysis from the cohort of the TAVI-SMALL (International Multicenter Registry to Evaluate the Performance of Self-Expandable Valves in Small Aortic Annuli) registry, which included patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area <400 mm2 on computed tomography) treated with transcatheter SEVs: 445 patients with (n = 129) and without (n = 316) PPM were enrolled. Intra-annular valves conferred increased risk for PPM (odds ratio [OR]: 2.36; 95% confidence interval [CI]: 1.16 to 4.81), while post-dilation (OR: 0.46; 95% CI: 0.25-0.84) and valve oversizing (OR: 0.53; 95% CI: 0.28-1.00) seemed to protect against PPM occurrence. At a median follow-...Continue Reading

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Citations

Jun 12, 2021·JACC. Cardiovascular Interventions·Howard C Herrmann
Jul 25, 2021·Internal and Emergency Medicine·Fabio Alfredo SguraGiuseppe Boriani
Oct 2, 2021·Journal of Cardiac Surgery·Walid IbrahimCesar E Mendoza
Oct 12, 2021·Trends in Cardiovascular Medicine·Zachary TugaoenJohn Vavalle

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