Prosthesis-patient mismatch in high-risk patients with severe aortic stenosis: A randomized trial of a self-expanding prosthesis

George L. Zorn, Stephen H. Little, Peter Tadros, G. Michael Deeb, Thomas G. Gleason, John Heiser, Neal S. Kleiman, Jae Kuen Oh, Jeffrey J. Popma, David Adams, Jian Huang, Michael J. Reardon

Research output: Contribution to journalArticle

56 Scopus citations

Abstract

Objectives We compared the incidence of prosthesis-patient mismatch (PPM) between transcatheter aortic valve replacement (TAVR) using a self-expanding bioprosthesis and surgical aortic valve replacement (SAVR) in the CoreValve US High Risk Pivotal Trial. We sought to determine the influence of PPM on clinical outcomes. Methods Patients with severe aortic stenosis and at increased risk for surgery were randomized 1:1 to TAVR or SAVR. Postoperative PPM was defined by the effective orifice area index (EOAi) as severe PPM (EOAi ≤ 0.65 cm2/m2) and no severe PPM (EOAi > 0.65 cm2/m2); clinical outcomes were analyzed in the TAVR arm (n = 389) and SAVR arm (n = 353). Left ventricular mass index and regression were analyzed at baseline and 1 year. Results The incidence of severe PPM in the SAVR group at 1 year was 25.7% versus 6.2% in the TAVR group (P

Original languageEnglish (US)
Pages (from-to)1014-1023.e3
JournalJournal of Thoracic and Cardiovascular Surgery
Volume151
Issue number4
DOIs
StatePublished - Apr 1 2016

Keywords

  • aortic stenosis
  • prosthesis-patient mismatch
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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    Zorn, G. L., Little, S. H., Tadros, P., Deeb, G. M., Gleason, T. G., Heiser, J., Kleiman, N. S., Oh, J. K., Popma, J. J., Adams, D., Huang, J., & Reardon, M. J. (2016). Prosthesis-patient mismatch in high-risk patients with severe aortic stenosis: A randomized trial of a self-expanding prosthesis. Journal of Thoracic and Cardiovascular Surgery, 151(4), 1014-1023.e3. https://doi.org/10.1016/j.jtcvs.2015.10.070