Key result
Severe PPM post-TAVR linked to ~5-fold higher 1-year mortality in very small annuli.
Why the study?
Adverse hemodynamics after TAVR are more common in patients with a small aortic annulus and affect clinical outcomes, but detailed associations were not fully characterized.
Observational (n=628)
Severe PPM was associated with higher mortality after TAVR in very small annuli; hypothesis-generating for prosthesis selection in younger patients.
Key Points Adverse hemodynamics after transcatheter aortic valve replacement (TAVR) are more common in patients with a small aortic annulus (SAA) and affect clinical outcomes. In this observational study of 628 patients with a very SAA, 89% of whom were women, severe prothesis patient mismatch (PPM) was associated with an up to fivefold increase in 1‐year mortality. As younger and more active patients are treated with TAVR, it will be important to consider strategies including prosthesis choice as well as surgical root enlargement to avoid severe PPM.
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Howard C. Herrmann (2023) conducted an observational in Very small aortic annulus undergoing TAVR (n=628). Severe prosthesis patient mismatch (PPM) vs. No severe PPM (implied) was evaluated on 1-year mortality (up to fivefold increase). Severe prosthesis patient mismatch after TAVR in patients with a very small aortic annulus was associated with an up to fivefold increase in 1-year mortality.
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