Key result
TAVI linked to ~71% lower risk of mild-to-moderate patient-prosthesis mismatch versus SAVR.
Why the study?
The outcomes and incidence of postoperative patient-prothesis mismatch after surgical aortic valve replacement using supra-annular bioprosthesis and transcatheter aortic valve implantation were not well characterized.
Does transcatheter aortic valve implantation compared to surgical aortic valve replacement reduce patient-prosthesis mismatch in high-risk patients with severe aortic stenosis?
Observational (n=73)
Does transcatheter aortic valve implantation compared to surgical aortic valve replacement reduce patient-prosthesis mismatch in high-risk patients with severe aortic stenosis?
Absolute Event Rate: 8.1% vs 27.8%
p-value: p=0.035
Transcatheter aortic valve implantation is associated with a lower incidence of mild-to-moderate patient-prosthesis mismatch compared to surgical aortic valve replacement in high-risk patients with severe aortic stenosis, though mid-term mortality remains similar.
BACKGROUND: The aim of this study is to analyze the outcomes and incidence of postoperative patient-prothesis mismatch after surgical aortic valve replacement using supra-annular bioprosthesis and transcatheter aortic valve implantation. METHODS: , respectively. Both groups were compared in terms of patient-prothesis mismatch, postoperative outcomes, and mortality. RESULTS: The overall incidence of mild-to-moderate patient-prosthesis mismatch was 17.8% (13/73). No severe patient-prosthesis mismatch was observed. Mild-to-moderate patient-prosthesis mismatch was found in three patients (8.1%) in the transcatheter group and in 10 patients (27.8%) in the surgery group (p=0.035). Body surface area was the significant predictor of patient-prosthesis mismatch (p=0.007). Diameters of bioprosthetic valves in the surgery and transcatheter groups were 21.4±2 and 23.9±2.6 mm, respectively (p=0.002). Early mortality and pacemaker implantation rates were higher in the transcatheter group (p>0.05). Postoperative outcomes were similar between the groups. Mid-term mortality at a mean follow-up of 47.7±7.3 months was similar between the groups (p=0.158). CONCLUSION: In high-risk patients with severe aortic stenosis, patientprosthesis mismatch is mild-to-moderate after surgical aortic valve replacement and transcatheter aortic valve implantation; however, this has no effect on early mortality. Based on our study results, we suggest that the use of surgical approach for aortic valve replacement may prevent potential complications of transcatheter aortic valve implantation.
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Bilge Ecemiş Yılmaz (2019) conducted an observational in Severe aortic stenosis (n=73). Transcatheter aortic valve implantation vs. Surgical aortic valve replacement was evaluated on Mild-to-moderate patient-prosthesis mismatch (p=0.035). Transcatheter aortic valve implantation was associated with a lower incidence of mild-to-moderate patient-prosthesis mismatch compared to surgical replacement (8.1% vs 27.8%; p=0.035).
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