Does prosthesis-patient mismatch (PPM) impact long-term mortality in patients undergoing TAVR?
Prosthesis-patient mismatch following TAVR was not associated with an increased risk of death over long-term follow-up, and predicted EOAi yields lower estimates of PPM severity than measured EOAi.
BACKGROUND: Both measured and predicted effective orifice area (EOA) indexed to the body surface area (EOAi) have been suggested to define prosthesis-patient mismatch (PPM) in patients undergoing transcatheter aortic valve replacement (TAVR). The impact of PPM on clinical outcomes may accumulate with extended follow-up and vary according to the definition used. AIMS: We aimed to investigate the long-term clinical impact of PPM in patients undergoing TAVR. METHODS: ). RESULTS: had a lower risk of 10-year all-cause mortality compared with those without PPM (adjusted hazard ratio: 0.73, 95% confidence interval: 0.55-0.96). CONCLUSIONS: The use of predicted versus measured EOAi results in a lower estimate of PPM severity. We observed no increased risk of death in patients with PPM over a median follow-up time of 429 days. CLINICALTRIALS: gov: NCT01368250.
Tomii et al. (Wed,) studied this question.