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Prevalence, predictors, and outcomes of patient prosthesis mismatch in women undergoing TAVI for severe aortic stenosis: Insights from the WIN‐TAVI registry
Author(s) -
Panoulas Vasileios F.,
Chandrasekhar Jaya,
Busi Gherardo,
Ruparelia Neil,
Zhang Zhongjie,
Mehilli Julinda,
Sartori Samantha,
Lefèvre Thierre,
Presbitero Patrizia,
Capranzano Piera,
Tchetche Didier,
Iadanza Alessandro,
Sardella Gennaro,
Van Mieghem Nicolas M.,
Meliga Emanuele,
Dumonteil Nicolas,
Fraccaro Chiara,
Trabattoni Daniela,
Sharma Samin,
FerrerGracia MariaCruz,
Naber Christoph K.,
Kievit Peter C.,
Snyder Clayton,
Sutaria Nilesh,
Sen Sayan,
Malik Iqbal S.,
Morice MarieClaude,
Nihoyannopoulos Petros,
Petronio Anna Sonia,
Mehran Roxana,
Chieffo Alaide,
Mikhail Ghada W.
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29227
Subject(s) - medicine , aortic valve replacement , stenosis , cardiology , prosthesis , aortic valve , incidence (geometry) , population , aortic valve stenosis , balloon , surgery , physics , environmental health , optics
Objective To evaluate the incidence, predictors and outcomes of female patients with patient‐prosthesis mismatch (PPM) following transcatheter aortic valve intervention (TAVI) for severe aortic stenosis (AS). Background Female AS TAVI recipients have a significantly lower mortality than surgical aortic valve replacement (SAVR) recipients, which could be attributed to the potentially lower PPM rates. TAVI has been associated with lower rates of PPM compared to SAVR. PPM in females post TAVI has not been investigated to date. Methods The WIN‐TAVI (Women's INternational Transcatheter Aortic Valve Implantation) registry is a multicenter registry of women undergoing TAVR for severe symptomatic AS. Two hundred and fifty patients with detailed periprocedural and follow‐up echocardiographic investigations were included in the WIN‐TAVI echocardiographic sub‐study. PPM was defined as per European guidelines stratified by the presence of obesity. Results The incidence of PPM in our population was 32.8%. Patients with PPM had significantly higher BMI (27.4 ± 6.1 vs. 25.2 ± 5.0, p = .002), smaller sized valves implanted (percentage of TAVI ≤23 mm 61% vs. 29.2%, PPM vs. no PPM, p < .001) and were more often treated with balloon expandable valves (48.3 vs. 32.5%, p < .001) rather than self expanding ones (26.3 vs. 52.8%, <.001). BMI (OR = 1.08; 95%CI 1.02–1.14, p = .011) and valve size ≤23 mm (OR = 3.00 95%CI 1.14–7.94, p = .027) were the only independent predictors of PPM. There was no significant interaction between valve size and valve type ( p = .203). No significant differences were observed in 1‐year mortality or major adverse cardiovascular events. Conclusions PPM in females undergoing TAVI occurs in one third of patients. BMI and valve size ≤23 mm are independent predictors. Larger registries are required to determine the impact of PPM on future clinical outcomes.