Hemodynamics after TAVR matter
Expert Article Analysis for: Prosthesis-patient mismatch after transcatheter implantation of contemporary balloon-expandable and self-expandable valves in small aortic annuli
Key Points
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Adverse hemodynamics after transcatheter aortic valve replacement (TAVR) are more common in patients with a small aortic annulus (SAA) and affect clinical outcomes.
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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.
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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.
CONFLICTS OF INTEREST STATEMENT
Howard C. Herrmann: Institutional grant support from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic. Consulting fees from Medtronic.
