Reclassification of prosthesis-patient mismatch after transcatheter aortic valve replacement using predicted vs. measured indexed effective orifice area

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dc.contributor.authorTernacle, Julien-
dc.contributor.authorGuimaraes, Leonardo-
dc.contributor.authorVincent, Flavien-
dc.contributor.authorCôté, Nancy-
dc.contributor.authorCôté, Mélanie-
dc.contributor.authorLachance, Dominique-
dc.contributor.authorClavel, Marie-Annick-
dc.contributor.authorPibarot, Philippe-
dc.contributor.authorRodés-Cabau, Josep-
dc.description.abstractAims : The objective was to compare the incidence and impact on outcomes of measured (PPMM) vs. predicted (PPMP) prosthesis–patient mismatch following transcatheter aortic valve replacement (TAVR). Methods and results : All consecutives patients who underwent TAVR between 2007 and 2018 were included. Effective orifice area (EOA) was measured by Doppler-echocardiography using the continuity equation and predicted according to the normal reference for each model and size of valve. PPM was defined using EOA indexed (EOAi) to body surface area as moderate if _ 30 kg/m2 ). The outcome endpoints were high residual gradient (>_20 mmHg) and the composite of cardiovascular mortality and hospital readmission for heart failure at 1 year. Overall, 1088 patients underwent a TAVR (55% male, age 79.1 ± 8.4 years, and STS score 6.6 ± 4.7%); balloon-expandable device was used in 83%. Incidence of moderate (10% vs. 27%) and severe (1% vs. 17%) PPM was markedly lower when defined by predicted vs. measured EOAi (P < 0.001). Balloon-expandable device implantation (OR: 1.90, P = 0.029) and valve-in-valve procedure (n = 118; OR: 3.21, P < 0.001) were the main factors associated with PPM occurrence. Compared with measured PPM, predicted PPM showed stronger association with high residual gradient. Severe measured or predicted PPM was not associated with clinical outcomes. Conclusion : The utilization of the predicted EOAi reclassifies the majority of patients with PPM to no PPM following TAVR. Compared with measured PPM, predicted PPM had stronger association with haemodynamic outcomes, while both methods were not associated with clinical
dc.publisherOxford University Pressfr
dc.subjectAortic stenosisfr
dc.subjectTranscatheter aortic valve replacementfr
dc.subjectProsthesis–patient mismatchfr
dc.subjectMeasured effective orifice areafr
dc.subjectPredicted effective orifice areafr
dc.titleReclassification of prosthesis-patient mismatch after transcatheter aortic valve replacement using predicted vs. measured indexed effective orifice areafr
dc.typeCOAR1_1::Texte::Périodique::Revue::Contribution à un journal::Article::Article de recherchefr
dcterms.bibliographicCitationEuropean Heart Journal. Cardiovascular Imaging, (2020)fr
dc.subject.rvmAorte -- Rétrécissement -- Pronosticfr
dc.subject.rvmValve aortique -- Chirurgie -- Complications et séquellesfr
rioxxterms.versionVersion of Recordfr
rioxxterms.project.funder_nameEdwards Lifesciencesfr
rioxxterms.project.funder_nameBoston Scientific Corporationfr
Collection:Articles publiés dans des revues avec comité de lecture

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