Five-Year Outcomes of Measured and Predicted Prosthesis-Patient Mismatch following Transcatheter Aortic Valve Implantation.

Autor: Al-Azizi K; Departments of Cardiology, Baylor Scott & White The Heart Hospital, Plano, Texas. Electronic address: Karim.alazizi@bswhealth.org., Moubarak G; Baylor Scott & White Research Institute, Plano, Texas., Mohiuddin A; Baylor Scott & White Research Institute, Plano, Texas., Szerlip M; Departments of Cardiology, Baylor Scott & White The Heart Hospital, Plano, Texas; Baylor Scott & White Research Institute, Plano, Texas., Potluri S; Departments of Cardiology, Baylor Scott & White The Heart Hospital, Plano, Texas., Harrington K; Departments of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas., Schaffer J; Departments of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas., Brinkman W; Departments of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas., Alsaid A; Departments of Cardiology, Baylor Scott & White The Heart Hospital, Plano, Texas., Wang Z; Departments of Cardiology, Baylor Scott & White The Heart Hospital, Plano, Texas., Ladner J; Baylor Scott & White Research Institute, Plano, Texas., Gunukula R; Baylor Scott & White Research Institute, Plano, Texas., Parro C; Baylor Scott & White Research Institute, Plano, Texas., Ma TW; Baylor Scott & White Research Institute, Plano, Texas., Stoler R; Department of Cardiology, Baylor University Medical Center, Dallas, Texas., Chugh Y; Department of Cardiology, Baylor University Medical Center, Dallas, Texas., Banerjee S; Department of Cardiology, Baylor University Medical Center, Dallas, Texas., Mixon T; Department of Cardiology, Baylor Scott & White Medical Center, Temple, Texas., Widmer RJ; Department of Cardiology, Baylor Scott & White Medical Center, Temple, Texas., Caldera A; Department of Cardiology, Baylor Scott & White Medical Center, Round Rock, Texas., Contreras JC; Department of Cardiology, Baylor Scott & White Medical Center, Round Rock, Texas., Krueger A; Department of Cardiothoracic Surgery, Baylor Scott & White All Saints Medical Center, Fort Worth, Texas., Gray W; Department of Cardiology, Baylor Scott & White Medical Center, College Station, Texas., DiMaio JM; Baylor Scott & White Research Institute, Plano, Texas; Departments of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas., Mack MJ; Baylor Scott & White Research Institute, Plano, Texas; Departments of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2024 Nov 15; Vol. 231, pp. 11-19. Date of Electronic Publication: 2024 Aug 28.
DOI: 10.1016/j.amjcard.2024.08.013
Abstrakt: Data on the long-term outcomes of prosthesis patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI) remain controversial. This study aimed to investigate the incidence and clinical outcomes of measured PPM (PPM M ) and predicted PPM (PPM P ) in patients who underwent TAVI. This is a retrospective analysis of 3,016 patients who underwent TAVI at a large health care system between 2012 and 2021. Effective orifice area indexed to body surface area (EOAi) was measured at discharge using the continuity equation. EOAi was predicted according to the published predictive tables for each model and size of the valve. Primary end point was 5-year survival rate. Mean age was 80 years, and 55.6% were male. The mean Society of Thoracic Surgeons risk score was 4.66%. 74.9% of patients received a balloon-expandable valve (BEV), and 25.1% received a self-expanding valve (SEV). The incidence of severe PPM was markedly lower when defined by predicted versus measured EOAi (0.8% vs 6.3%, p <0.001) and when assessed in SEV versus BEV (5.3% vs 6.6%, p = 0.02). Neither severe PPM p nor severe PPM M was associated with 5-year mortality (hazard ratio 1.26, 95% confidence interval 0.96 to 1.66, p = 0.095; hazard ratio 1.03, 95% confidence interval 0.42 to 2.49, p = 0.954, respectively), irrespective of the presence of high residual pressure gradient. Neither BEV nor SEV was associated with an increased 5-year mortality, irrespective of PPM definition or severity. In this large health care system analysis, neither severe PPM P nor severe PPM M was associated with 5-year all-cause mortality. There was no difference between BEV and SEV in terms of mortality, irrespective of the definition or severity of PPM.
Competing Interests: Declaration of competing interest Dr. Al-Azizi: proctor/consultant Edwards Lifesciences, consultant/Advisory Board Medtronic, consultant Boston Scientific, and Speaker Bureau Philips. Dr. Szerlip: Edwards Lifesciences, proctor, speaker, and consultant; Abbott Vascular, advisory board, consultant, and proctor; Medtronic, steering committee; and Boston Scientific, speaker. Dr. Stoler: proctor and advisory board: MDT, BSCI, and Edwards; advisory board: Biotronik. Dr. Mack: Abbott, Trial Co-PI; Edwards Life Sciences, Trial Co-PI; and Medtronic, Trial Study Chair; all uncompensated. Dr. Potluri: advisory board, proctor, and speaker: Medtronic, Boston Scientific, Abbott, and Cordis; proctor and speaker: Edwards, Terumo, and AstraZeneca. The remaining authors have no competing interests to declare.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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