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Long-term outcome of prosthesis-patient mismatch after transcatheter aortic valve replacement.

Abstract：

BACKGROUND:Incidence and long-term clinical consequences of prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) are still unclear. METHODS:We enrolled 710 consecutive patients who underwent TAVR. PPM was defined as absent if the index orifice area (iEOA) was >0.85 cm2/m2, moderate if the iEOA was between 0.65 and 0.85 cm2/m2 or severe if the iEOA was <0.65 cm2/m2. RESULTS:Among the 566 patients fulfilling the study criteria, the distribution of PPM was as follows: 50.5% none (n = 286), 43% moderate PPM (n = 243) and 6.5% severe PPM (n = 37). At 5-year follow-up, patients with severe PPM had a significantly higher incidence of the combined endpoint of cardiovascular death, acute myocardial infarction and stroke (p = .025) compared with the other patients. After adjusting the results for possible confounders, severe PPM remained an independent predictor of long-term adverse outcome (HR: 2.46; 95% Confidence Interval: 1.10-5.53). The independent predictors of severe PPM were valve-in-valve procedure and body mass index. Balloon-expandable valves were not associated with higher rates of severe PPM in comparison with self-expandable valves (8% vs. 5%, respectively, p = .245). CONCLUSIONS:In our study severe PPM emerged as a risk factor for long-term major adverse cardiac and cerebrovascular events.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Compagnone M,Marchetti G,Taglieri N,Ghetti G,Bruno AG,Orzalkiewicz M,Marrozzini C,Bacchi Reggiani ML,Palmerini T,Galiè N,Saia F

doi

10.1016/j.ijcard.2020.06.033

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

27-31

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(20)33411-2

journal_volume

318

pub_type

杂志文章

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