Clinical research

DOI: 10.4244/EIJ-D-23-00011

Transcatheter aortic valve implantation in patients with extra-small aortic annuli

Gabriela Tirado-Conte1, MD; Josep Rodés-Cabau2, MD, PhD; Juan F. Oteo3, MD; Manuel Pan4, MD, PhD; Erika Muñoz5, MD; Guy Witberg6, MD; Asim N. Cheema7,8, MD; Alberto Alperi2, MD; Diego Lopez9, MD; Ignacio J. Amat-Santos10, MD, PhD; Mariama Akodad11, MD, PhD; Soledad Ojeda4, MD; Vicenc Serra12, MD; Sergio Garcia-Blas13, MD; Fernando Alfonso14, MD, PhD; Ole De Backer15, MD, PhD; Luis Asmarats16, MD, PhD; Antonio Muñoz5, MD; Ashraf Hamdan6, MD; Stefan Toggweiler17, MD; Raquel del Valle18, MD; Luisa Salido19, MD, PhD; Ignacio Cruz-González20, MD, PhD; Rodrigo Estevez-Loureiro21, MD, PhD; Luis Enrique Martin Alfaro22, MD; Livia Gheorghe22, MD; Maciec Dabrowski23, MD; Alberto Berenguer24, MD; Dabit Arzamendi14, MD, PhD; Francesco Saia25, MD; John G. Webb10, MD; Lars Sondergaard26, MD, PhD; Luis Nombela-Franco1, MD, PhD


Background: A small aortic annulus (SAA) is a risk factor for prosthesis-patient mismatch (PPM) in patients undergoing surgical or transcatheter aortic valve implantation (TAVI). Data regarding TAVI in patients with extra-SAA are scarce.

Aims: The aim of this study was to analyse the safety and efficacy of TAVI in patients with extra-SAA.

Methods: A multicentre registry study including patients with extra-SAA (defined as an aortic annulus area <280 mm2 and/or perimeter <60 mm) undergoing TAVI was established. Primary efficacy and safety endpoints were defined as device success and early safety at 30 days, respectively, using the Valve Academic Research Consortium-3 criteria, and were analysed according to valve type: self-expanding (SEV) versus balloon-expandable (BEV).

Results: A total of 150 patients were included, of which 139 (92.7%) were women, and 110 (73.3%) received an SEV. Intraprocedural technical success was 91.3%, with a higher rate in patients receiving an SEV (96.4% vs 77.5% with BEV; p=0.001). Overall, 30-day device success was 81.3%, (85.5% with SEV vs 70.0% with BEV; p=0.032). The primary safety endpoint occurred in 72.0% of patients (with no...

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Volume 19 Number 4
Jul 17, 2023
Volume 19 Number 4
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