Incidence and sequelae of prosthesis-patient mismatch in transcatheter versus surgical valve replacement in high-risk patients with severe aortic stenosis : a PARTNER trial cohort-A analysis.

DC FieldValueLanguage
dc.contributor.authorPibarot, Philippe-
dc.contributor.authorWeissman, Neil J.-
dc.contributor.authorStewart, William J.-
dc.contributor.authorHahn, Rebecca T.-
dc.contributor.authorLindman, Brian R.-
dc.contributor.authorMcAndrew, Thomas-
dc.contributor.authorKodali, Susheel K.-
dc.contributor.authorMack, Michael J.-
dc.contributor.authorThourani, Vinod H.-
dc.contributor.authorMiller, D. Craig-
dc.contributor.authorSvensson, Lars Gunnar-
dc.contributor.authorHerrmann, Howard C.-
dc.contributor.authorSmith, Craig R.-
dc.contributor.authorRodés-Cabau, Josep-
dc.contributor.authorWebb, John G. (John Graydon)-
dc.contributor.authorLim, Scott-
dc.contributor.authorXu, Ke-
dc.contributor.authorHueter, Irene-
dc.contributor.authorDouglas, Pamela S.-
dc.contributor.authorLeon, Martin B.-
dc.date.accessioned2016-06-07T15:01:18Z-
dc.date.available10000-01-01-
dc.date.issued2014-09-30-
dc.identifier.issn0735-1097fr_CA
dc.identifier.urihttp://hdl.handle.net/20.500.11794/3448-
dc.description.abstractBACKGROUND : Little is known about the incidence of prosthesis-patient mismatch (PPM) and its impact on outcomes after transcatheter aortic valve replacement (TAVR). OBJECTIVES : The objectives of this study were: 1) to compare the incidence of PPM in the TAVR and surgical aortic valve replacement (SAVR) randomized control trial (RCT) arms of the PARTNER (Placement of AoRTic TraNscathetER Valves) I Trial cohort A; and 2) to assess the impact of PPM on regression of left ventricular (LV) hypertrophy and mortality in these 2 arms and in the TAVR nonrandomized continued access (NRCA) registry cohort. METHODS : The PARTNER Trial cohort A randomized patients 1:1 to TAVR or bioprosthetic SAVR. Postoperative PPM was defined as absent if the indexed effective orifice area (EOA) was >0.85 cm2/m2, moderate if the indexed EOA was $0.65 but #0.85 cm2/m2, or severe if the indexed EOA was <0.65 cm2/m2. LV mass regression and mortality were analyzed using the SAVR-RCT (n ¼ 270), TAVR-RCT (n ¼ 304), and TAVR-NRCA (n ¼ 1,637) cohorts. RESULTS : The incidence of PPM was 60.0% (severe: 28.1%) in the SAVR-RCT cohort versus 46.4% (severe: 19.7%) in the TAVR-RCT cohort (p < 0.001) and 43.8% (severe: 13.6%) in the TAVR-NRCA cohort. In patients with an aortic annulus diameter <20 mm, severe PPM developed in 33.7% undergoing SAVR compared with 19.0% undergoing TAVR (p¼0.002). PPM was an independent predictor of less LV mass regression at 1 year in the SAVR-RCT (p¼0.017) and TAVRNRCA (p ¼ 0.012) cohorts but not in the TAVR-RCT cohort (p ¼ 0.35). Severe PPM was an independent predictor of 2-year mortality in the SAVR-RCT cohort (hazard ratio [HR]: 1.78; p ¼ 0.041) but not in the TAVR-RCT cohort (HR: 0.58; p ¼ 0.11). In the TAVR-NRCA cohort, severe PPM was not a predictor of 1-year mortality in all patients (HR: 1.05; p ¼ 0.60) but did independently predict mortality in the subset of patients with no post-procedural aortic regurgitation (HR: 1.88; p ¼ 0.02). CONCLUSIONS : In patients with severe aortic stenosis and high surgical risk, PPM is more frequent and more often severe after SAVR than TAVR. Patients with PPM after SAVR have worse survival and less LV mass regression than those without PPM. Severe PPM also has a significant impact on survival after TAVR in the subset of patients with no post-procedural aortic regurgitation. TAVR may be preferable to SAVR in patients with a small aortic annulus whoare susceptible toPPMto avoid its adverse impact on LV mass regression and survival. (The PARTNER Trial: Placement of AoRTic TraNscathetER Valve ; NCT00530894).fr_CA
dc.languageengfr_CA
dc.publisherElsevier Biomedicalfr_CA
dc.subjectAortic regurgitationfr_CA
dc.subjectDoppler echocardiographyfr_CA
dc.subjectLeft ventricular mass regressionfr_CA
dc.subjectMortalityfr_CA
dc.titleIncidence and sequelae of prosthesis-patient mismatch in transcatheter versus surgical valve replacement in high-risk patients with severe aortic stenosis : a PARTNER trial cohort-A analysis.fr_CA
dc.typeCOAR1_1::Texte::Périodique::Revue::Contribution à un journal::Article::Article de recherche-
dcterms.bibliographicCitationJournal of the American College of Cardiology, Vol. 64 (13), 1323–1334 (2014)fr_CA
dc.audienceProfesseurs (Enseignement supérieur)fr_CA
dc.audienceÉtudiantsfr_CA
dc.audienceDoctorantsfr_CA
dc.audienceMédecinsfr_CA
dc.identifier.doi10.1016/j.jacc.2014.06.1195fr_CA
dc.identifier.pubmed25257633fr_CA
dc.subject.rvmCœur -- Valvules -- Maladiesfr_CA
dc.subject.rvmÉchocardiographie Dopplerfr_CA
dc.subject.rvmCœur -- Ventricule gauche -- Maladiesfr_CA
dc.subject.rvmMortalitéfr_CA
rioxxterms.versionVersion of Recordfr_CA
rioxxterms.version_of_recordhttps://doi.org/10.1016/j.jacc.2014.06.1195fr_CA
bul.rights.periodeEmbargoInfinifr_CA
Collection:Articles publiés dans des revues avec comité de lecture

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