Hemodynamic and Clinical Impact of Prosthesis–Patient Mismatch After Transcatheter Aortic Valve Implantation

Abstract

PPM may be observed after TAVI and when present may be accompanied by less favorable changes in transvalvular hemodynamics, limited LV mass regression, persistent elevated LV filling pressure, and less improvement in clinical functional status.

Transcatheter Aortic Valve Replacement

“…Porcelain aorta was defined as an extensive circumferential calcification of the thoracic aorta, as assessed by computed tomography and/or fluoroscopy (14). Patient-prosthesis mismatch was defined as an indexed effective orifice area Յ0.85 cm 2 /m 2 (18,19).…”

Changing Strategy for Aortic Stenosis by Transcatheter Valve Treatment in Japan

“…Prosthesis-patient mismatch (PPM) is a concern after SAVR for severe AS, but currently PPM is thought to be absent after TAVR when a correctly sized transcatheter heart valve is selected in relation to the annular size, except with the valve-in-valve technique. 13 Neurologic complication is an ominous problem after SAVR. Stroke is thought to be caused by embolism during manipulation of the diseased aorta or jet flow to the atheroma, and neurocognitive dysfunction is caused by cerebral microembolism during cardiopulmonary bypass.…”

Valve Prosthesis–Patient Mismatch (VP–PM)

“…VP-PM has been described in percutaneously implanted aortic valves. The incidence of severe VP-PM in the Edwards Sapien valve has been reported to be 11% to 18.2% when measured 6 to 12 months after implantation (72,73). In the Medtronic Corevalve, the incidence of severe VP-PM has been reported to be 2% to 16% when measured at the time of hospital discharge (74 -76).…”