Clinical research

DOI: 10.4244/EIJ-D-23-00456

Long-term outcomes of measured and predicted prosthesis-patient mismatch following transcatheter aortic valve replacement

Daijiro Tomii1, MD; Taishi Okuno1, MD; Dik Heg2, PhD; Masaaki Nakase1, MD; Jonas Lanz1, MD, MSc; Fabien Praz1, MD; Stefan Stortecky1, MD, MPH; David Reineke3, MD; Stephan Windecker1, MD; Thomas Pilgrim1, MD, MSc


Background: Both measured and predicted effective orifice area (EOA) indexed to the body surface area (EOAi) have been suggested to define prosthesis-patient mismatch (PPM) in patients undergoing transcatheter aortic valve replacement (TAVR). The impact of PPM on clinical outcomes may accumulate with extended follow-up and vary according to the definition used.

Aims: We aimed to investigate the long-term clinical impact of PPM in patients undergoing TAVR.

Methods: Patients in a prospective TAVR registry were stratified by the presence of moderate (0.65-0.85 or 0.55-0.70 cm2/m2 if obese) or severe (≤0.65 or ≤0.55 cm2/m2 if obese) PPM according to echocardiographically measured EOAi (measured PPM), predicted EOAi based on published EOA reference values for each valve model and size (predicted PPMTHV), or predicted EOAi based on EOA reference values derived from computed tomography measurements of aortic annulus dimensions (predicted PPMCT).

Results: In an analysis of 2,463 patients, the frequency of measured PPM (moderate: 27.0%; severe: 8.7%) was higher than the frequency of predicted PPMTHV (moderate: 11.3%; severe: 1.2%) or predicted PPMCT (moderate: 12.0%; severe: 0.1%). During a median follow-up of 429...

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Volume 19 Number 9
Nov 17, 2023
Volume 19 Number 9
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