Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry
Key result
Post-TAVI paravalvular leak ≥2 is linked to higher long-term mortality, but patient-prosthesis mismatch is not.
- n=47,494
Why the study?
Paravalvular leak and patient-prosthesis mismatch are frequent complications after TAVI, but their respective impacts on long-term clinical outcomes including mortality remain unclear.
Does paravalvular leak or patient-prosthesis mismatch increase long-term mortality in patients following transcatheter aortic valve implantation?
Population
47,494 patients who underwent TAVI for symptomatic severe aortic stenosis in France from 2010 to 2019
Comparison
Patients with PVL ≥ 2 or moderate-to-severe PPM versus those without these complications
Design
Cohort study using the France-TAVI registry
Follow-up
6.5 years
Authors
Discussion
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Member takes
Implication
Supports intensified post-TAVI surveillance for moderate-to-severe paravalvular leak; leaves open whether mitigation improves survival in this observational cohort.
Study Design
Type
Cohort (n=47,494)
Multicenter
Yes
Structured PICO
Does paravalvular leak or patient-prosthesis mismatch increase long-term mortality in patients following transcatheter aortic valve implantation?
P
Population
47,494 patients with symptomatic severe aortic stenosis who underwent TAVI in France between 2010 and 2019, followed for up to 6.5 years.
E
Exposure
Presence of paravalvular leak (PVL ≥ 2) or moderate-to-severe patient-prosthesis mismatch (PPM) following TAVI
C
Comparator
Patients without PVL ≥ 2 or moderate-to-severe PPM following TAVI
O
Outcome
Long-term mortality at 6.5 yearshard clinical
In a large national registry, moderate-to-severe paravalvular leak, but not patient-prosthesis mismatch, was independently associated with increased long-term mortality after TAVI.
Cite This Study
Deharo et al. (2022) conducted a cohort in Symptomatic severe aortic stenosis (n=47,494). Paravalvular leak (PVL ≥ 2) and moderate-to-severe patient-prosthesis mismatch (PPM) vs. Absence of significant PVL or PPM was evaluated on Mortality. At 6.5 years follow-up, paravalvular leak ≥ 2 following TAVI was an independent predictor of higher mortality, whereas patient-prosthesis mismatch was not associated with increased mortality risk.