Prosthesis-patient mismatch following transcatheter aortic valve replacement for degenerated transcatheter aortic valves : the TRANSIT-PPM international project
Testa, Luca (IRCCS Policlinico S. Donato)
Casenghi, Matteo (IRCCS Policlinico S. Donato)
Criscione, Enrico (IRCCS Policlinico S. Donato)
Van Mieghem, Nicolas M. (Erasmus University Medical Center)
Tchétché, Didier (Clinique Pasteur)
Asgar, Anita W. (Montreal Heart Institute)
De Backer, Ole (Copenhagen University Hospital)
Latib, Azeem (Montefiore Medical Center)
Reimers, Bernhard (CCS Humanitas Research Hospital)
Stefanini, Giulio (Humanitas University)
Trani, Carlo (Policlinico Universitario A. Gemelli)
Giannini, Francesco (Maria Cecilia Hospital)
Bartorelli, Antonio (University of Milan)
Wojakowski, Wojtek (Medical University of Silesia)
Dabrowski, Maciej (National Institute of Cardiology)
Jagielak, Dariusz (Medical University)
Banning, Adrian P. (John Radcliffe Hospital (Oxford, Regne Unit))
Kharbanda, Rajesh (John Radcliffe Hospital (Oxford, Regne Unit))
Moreno, Raul (Hospital Universitario La Paz (Madrid))
Schofer, Joachim (MVZ Department Structural Heart Disease at St. Georg)
Brinkmann, Christina (MVZ Department Structural Heart Disease at St. Georg)
van Royen, Niels (Radboud University Medical Center)
Pinto, Duane (Beth Israel Deaconess Medical Center)
Serra, Antoni (Institut d'Investigació Biomèdica Sant Pau)
Segev, Amit (Chaim Sheba Medical Center (Israel))
Giordano, Arturo (Pineta Grande Hospital)
Brambilla, Nedy (IRCCS Policlinico S. Donato)
Agnifili, Mauro. (IRCCS Policlinico S. Donato)
Rubbio, Antonio Popolo (IRCCS Policlinico S. Donato)
Squillace, Mattia (IRCCS Policlinico S. Donato)
Oreglia, Jacopo (Niguarda Ca Granda Hospital)
Tanja, Rudolph (Heart and Diabetes Center NRW)
McCabe, James M. (University of Washington)
Abizaid, Alexander (Instituto do Coração (Incor))
Voskuil, Michiel (University Medical Center)
Teles, Rui (Centro Hospitalar de Lisboa Ocidental)
Zoccai, Giuseppe Biondi (Mediterranea Cardiocentro)
Sondergaard, Lars (Montreal Heart Institute)
Bedogni, Francesco (IRCCS Policlinico S. Donato)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	A severe prosthesis-patient mismatch (PPM) is associated with adverse outcomes following transcatheter aortic valve replacement (TAVR) for de novo aortic stenosis or a failed surgical bioprosthesis. The impact of severe PPM in patients undergoing TAV-in-TAVR is unknown. We sought to investigate the incidence and 1-year outcomes of different grades of PPM in patients undergoing TAV-in-TAVR. The TRANSIT-PPM is an international registry, including cases of degenerated TAVR treated with a second TAVR. PPM severity, as well as in-hospital, 30-day, and 1-year outcomes were defined according to the Valve Academic Research Consortium-3 (VARC-3) criteria. Among 28 centers, 155 patients were included. Severe PPM was found in 6. 5% of patients, whereas moderate PPM was found in 14. 2% of patients. The rate of severe PPM was higher in patients who underwent TAV-in-TAVR with a second supra-annular self-expanding (S-SE) TAVR (10%, p = 0. 04). Specifically, the rate of severe PPM was significantly higher among cases of a SE TAVR implanted into a balloon-expandable (BE) device (19%, p = 0. 003). At 1-year follow-up, the rate of all-cause mortality, and the rate of patients in the New York Heart Association (NYHA) class III/IV were significantly higher in the cohort of patients with severe PPM (p = 0. 016 and p = 0. 0001, respectively). Almost all the patients with a severe PPM after the first TAVR had a failed < 23 mm BE transcatheter heart valve (THV): the treatment with an S-SE resolved the severe PPM in the majority of the cases. After TAV-in-TAVR, in a fifth of the cases, a moderate or severe PPM occurred. A severe PPM is associated with an increased 1-year all-cause mortality.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	TAVR ; TAVR in TAVR ; Failed TAVR ; Mortality ; Prosthesis-patient mismatch
Publicat a:	Frontiers in Cardiovascular Medicine, Vol. 9 (29 2022) , p. 931207, ISSN 2297-055X

DOI: 10.3389/fcvm.2022.931207
PMID: 35966561

11 p, 1.3 MB

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