Author + information
- Konstantinos Stathogiannis,
- Konstantinos Toutouzas,
- Konstantinos Spargias,
- George Latsios,
- Andreas Synetos,
- Antonios Mastrokostopoulos,
- Stella Brili,
- Michalis Chrissoheris,
- Antonios Chalapas,
- Aias Antoniades,
- Gregory Pavlides and
- Christodoulos Stefanadis
Prosthesis–patient mismatch (PPM) is considered to be an index of prosthetic valve dysfunction after transcatheter aortic valve replacement (TAVR) according to VARC–2 criteria. We investigated the significance and predictors of PPM in patients undergoing TAVR.
Procedural, clinical and echocardiographic parameters [aortic valve annulus diameter, left ventricular ejection fraction (LVEF), pulmonary artery systolic pressure (PASP)], transvalvular gradients, and effective valve orifice (EOA) were recorded at baseline and prior to discharge in 157 patients undergoing TAVR. PPM was defined as moderate when indexed effective orifice area (EOAi)≤0.85cm2/m2and severe when EOAi<0.65cm2/m2.
There was a reduction in mean (50.8±14.3 to 9.4±4 mmHg, p<0.001) and peak gradients (84.2±20 to 18±7.8 mmHg, p<0.001). Fifty–five patients (35%) had moderate and 11 (7%) severe PPM. Fourteen patients (8%) suffered major vascular complications; of these, 7 (50%) had PPM (P<0.5). At 30 days 3 patients died, none with PPM. Unadjusted predictors for PPM were: female gender, height, weight, logEuroSCORE, pre–LVEF, pre mean gradient>40mmHg, pre–TAVR PASP (>55mmHg), and moderate/severe mitral regurgitation pre TAVR. Independent predictive factors of PPM are shown in the Table.
Although PPM is a frequent finding post TAVR, patients suffering from PPM did not have increased rates of death or major vascular complications compared to patients without PPM.
|Variables||OR||95% CI||P value|
|PASP >55mmHg pre-TAVR||0.214||0.053–0.876||0.032|
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Structural Heart Disease Intervention
Abstract Category: 49. TCT@ACC–i2: Aortic Valve Disease
Presentation Number: 2114–243
- 2013 American College of Cardiology Foundation