Key result
Prosthesis-patient mismatch after SAPIEN 3 implantation linked to ~217% greater 1-year CHF risk.
Why the study?
Little is known about the effect of prosthesis-patient mismatch on outcomes after transcatheter aortic valve replacement with the SAPIEN 3 valve.
Does prosthesis-patient mismatch increase the risk of hospitalization for congestive heart failure at 1 year in patients with severe symptomatic aortic stenosis implanted with S3-THV?
Cohort
Does prosthesis-patient mismatch increase the risk of hospitalization for congestive heart failure at 1 year in patients with severe symptomatic aortic stenosis implanted with S3-THV?
Prosthesis-patient mismatch after TAVR with the SAPIEN 3 valve is strongly associated with an increased risk of heart failure hospitalization at 1 year, particularly in patients with significant mitral regurgitation.
Answers are grounded in this paper and cite their sources.
PPM after S3-THV was associated with higher 1-year hospitalization risk; leaves open whether preventing mismatch improves TAVR outcomes.
BACKGROUND: Little is known about the effect of prosthesis-patient mismatch (PPM) on outcomes after transcatheter aortic valve replacement. We reported previously an increased risk of PPM with the SAPIEN 3 transcatheter heart valve (S3-THV). AIMS: To investigate the association of PPM with 1-year outcomes in patients with severe aortic stenosis (AS) implanted with S3-THV. METHODS: . Inclusion criteria were severe symptomatic AS and implantation with S3-THV. The primary endpoint was hospitalization for congestive heart failure (CHF) at 1 year; the secondary endpoint was all-cause mortality. RESULTS: ; P<0.001) and a higher mean gradient (14±4.6 vs 11.9±3.9mmHg; P<0.001). CHF occurred in 16.5% vs 7% (P=0.03). By multivariable analysis, PPM was independently associated with CHF (hazard ratio [HR] 3.17, 95% confidence interval [CI] 1.17 to 8.55; P=0.032), especially in patients with mitral regurgitation≥2/4 (HR>100, 95%CI>100 to>1000; P<0.01). PPM did not correlate with all-cause mortality (HR 0.90, 95%CI 0.22 to 3.03; P=0.86). CONCLUSIONS: PPM after S3-THV implantation is strongly associated with CHF at 1 year, but is not correlated with overall mortality.
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Théron et al. (2021) conducted a cohort in Severe symptomatic aortic stenosis. Prosthesis-patient mismatch (PPM) vs. No prosthesis-patient mismatch was evaluated on Hospitalization for congestive heart failure (CHF) at 1 year (HR 3.17, 95% CI 1.17 to 8.55, p=0.032). Prosthesis-patient mismatch after SAPIEN 3 transcatheter heart valve implantation was independently associated with congestive heart failure at 1 year (HR 3.17; 95% CI 1.17-8.55; P=0.032).
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