Moderate transcatheter aortic valve oversizing (10-20%) was independently associated with lower all-cause mortality compared to minimal oversizing (HR 0.63; 95% CI 0.43-0.89; p=0.02).
Cohort (n=1,808)
No
Does the degree of transcatheter aortic valve oversizing affect clinical outcomes and mortality in patients undergoing TAVR?
An oversizing range of 10-20% during TAVR is associated with lower all-cause mortality without an accompanying increase in early procedural complications.
Effect estimate: HR 0.63 (95% CI 0.43-0.89)
p-value: p=0.02
Optimal valve sizing is critical in transcatheter aortic valve replacement (TAVR) to minimize complications and provide the best clinical and hemodynamic results. The objective of this study was to evaluate whether increasing degrees of transcatheter aortic valve oversizing are associated with differences in patient outcomes following TAVR. A retrospective analysis was conducted to identify patients who underwent TAVR from 2010-2025 using our institutional registry. Oversizing was defined as the ratio of the implanted transcatheter heart valve size to the pre-procedural annular diameter. Patients were split into three groups: minimal oversizing (< 10% oversize), moderate oversizing (10-< 20%) and severe oversizing (≥ 20%). A total of 1,808 patients were included: 180 (10%) in the minimal oversizing group, 433 (24%) in the moderate oversizing group, and 1,195 (66%) in the severe oversizing group. The mean age across groups was 80.0 ± 7.2 years. There were no statistically significant differences in early outcomes, such as valve implantation success rates, post-operative stroke incidence, or new pacemaker implantation among the groups. However, a multivariable analysis demonstrated that the moderate oversizing group was independently associated with a lower all-cause mortality (HR = 0.63; 95% CI 0.43-0.89; p = 0.02), while severe oversizing had equivalent (HR = 0.82; 95% CI 0.52-1.25; p = 0.35). The incidence of paravalvular leak at 1 year and follow-up aortic valve reintervention rates were similar across groups. An oversizing range of 10-20% during TAVR was associated with lower all-cause mortality without an accompanying increase in early procedural complications.
Ogami et al. (Mon,) conducted a cohort in Patients undergoing transcatheter aortic valve replacement (TAVR) (n=1,808). Moderate (10-<20%) or severe (≥20%) transcatheter aortic valve oversizing vs. Minimal oversizing (<10%) was evaluated on All-cause mortality (HR 0.63, 95% CI 0.43-0.89, p=0.02). Moderate transcatheter aortic valve oversizing (10-20%) was independently associated with lower all-cause mortality compared to minimal oversizing (HR 0.63; 95% CI 0.43-0.89; p=0.02).