Prosthesis-patient mismatch is an independent predictor of congestive heart failure after transcatheter aortic valve replacement

Théron, Alexis; Lavagna, F; Gaubert, Guillaume; Resseguier, Noémie; Porto, Alizée; Ferrara, Jérôme; Jaussaud, Nicolas; Morera, Pierre; Cuisset, Thomas; Deharo, Pierre; Collart, Frédéric

doi:10.1016/j.acvd.2020.11.005

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…Observational studies have reported that some degree of PPM occurs in 24%–35% of patients 14 . The incidence of severe PPM has been reported to vary between 4.8%–6% 14,38 . Reports of PPM and its negative impact on survival in TAVR also vary.…”

Section: Discussionmentioning

confidence: 99%

“…There are several baseline clinical characteristics, previously discussed for SAVR, which are also predictive of PPM in TAVR. As seen in SAVR, female sex, younger age, higher BMI, and smaller aortic annulus diameter have all been reported as independent risk factors for the development of PPM in TAVR 14,38 EOA indexed to body surface area, however, may lead to an overestimation of PPM in patients with obesity. Thus, recent recommendations suggest applying lower cutoff values of EOA in the patient with BMI ≥ 30: 0.70-0.56 cm 2 /m 2 for moderate PPM, and ≤0.55 m 2 /m 2 for severe PPM.…”

Section: Ppm In Tavrmentioning

confidence: 98%

“…14 The incidence of severe PPM has been reported to vary between 4.8%-6%. 14,38 Reports of PPM and its negative impact on survival in TAVR also vary. In contrast to SAVR literature, in TAVR, a meta-analysis examining the effect of PPM on survival showed no effect.…”

Section: Ppm In Tavrmentioning

confidence: 99%

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Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Alnajar

Hamad

Azhar

et al. 2022

Journal of Cardiac Surgery

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Background The hemodynamics of most prosthetic valves are often inferior to that of the normal native valve, and a significant proportion of patients undergoing surgical (SAVR) or transcatheter aortic valve replacement (TAVR) have high residual transaortic pressure gradients due to prosthesis–patient mismatch (PPM). As the experience with TAVR has increased and long‐term outcomes are reported, a close look at the PPM literature is required in light of new evidence. Methods For this review, we searched the Embase, Medline, and Cochrane databases from 2000 to 2022. Articles reporting PPM as an outcome following aortic valve replacements were identified and reviewed. Results The impact of PPM on clinical outcomes in aortic valve replacement has not been clear as multiple studies failed to report PPM incidence. However, the PPM outcomes after SAVR vary more widely than after TAVR, ranging from 8% to 80% in SAVR and from 24% to 35% in TAVR. Incidence of severe PPM following redo SAVR ranges from 2% to 9% and following valve‐in‐valve TAVR is from 14% to 33%, however, while PPM is higher in valve‐in‐valve TAVR, patients had better survival rates. Conclusions The gap between valve performance and clinical outcomes in SAVR and TAVR could be reduced by carefully selecting patients for either treatment option. Understanding predictors of PPM can add to the safety, effectiveness, and increased survival benefit of both SAVR and TAVR.

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Section: Discussionmentioning

confidence: 99%

Section: Ppm In Tavrmentioning

confidence: 98%

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Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Alnajar

Hamad

Azhar

et al. 2022

Journal of Cardiac Surgery

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“…and post-procedural blood transfusion. 6,[57][58][59] HF readmission, especially beyond 30 days post-TAVR, has been associated with nearly two-to three-fold higher risk of all-cause mortality. 6,57 A prospective Canadian study reported that HF readmission within 1 year was associated with an adjusted three-fold higher risk of death (HR 3.17, 95% CI 1.44-4.44).…”

Section: Readmission For Heart Failurementioning

confidence: 99%

“…Among patients readmitted for HF, 64% were noted to have a single readmission over the year, while the remaining 36% had multiple readmissions for HF 6 . Predictors of HF readmission have included higher STS mortality risk, prior acute HF, atrial fibrillation, diabetes mellitus, chronic kidney disease, chronic lung disease, pulmonary hypertension, lower AV gradient, patient–prosthesis mismatch, transapical access, and post‐procedural blood transfusion 6,57–59 . HF readmission, especially beyond 30 days post‐TAVR, has been associated with nearly two‐ to three‐fold higher risk of all‐cause mortality 6,57 .…”

Section: Heart Failure Outcomes Following Transcatheter Aortic Valve ...mentioning

confidence: 99%

Transcatheter aortic valve replacement in heart failure

Parikh,

Mack,

Stone

et al. 2024

European J of Heart Fail

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Patients with severe aortic stenosis (AS) may develop heart failure (HF), the presence of which has traditionally been deemed as a final stage in AS progression with poor outcomes. The use of transcatheter aortic valve replacement (TAVR) has become the preferred therapy for most patients with AS and concomitant HF. With its instant afterload reduction, TAVR offers patients with HF significant haemodynamic benefits, with corresponding changes in left ventricular structure and improved mortality and quality of life. The prognostic covariates and optimal timing of TAVR in patients with less than severe AS remain unclear. The purpose of this review is to describe the association between TAVR and outcomes in patients with HF, particularly in the setting of left ventricular systolic dysfunction, acute HF, and right ventricular systolic dysfunction, and to highlight areas for future research.

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Late Outcomes After Aortic Root Enlargement During Aortic Valve Replacement: Meta-Analysis With Reconstructed Time-To-Event Data

Sá

Eynde

Amabile

et al. 2022

Journal of Cardiothoracic and Vascular Anesthesia

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Prosthesis-patient mismatch is an independent predictor of congestive heart failure after transcatheter aortic valve replacement

Cited by 4 publications

References 24 publications

Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Transcatheter aortic valve replacement in heart failure

Late Outcomes After Aortic Root Enlargement During Aortic Valve Replacement: Meta-Analysis With Reconstructed Time-To-Event Data

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