Prevalence, predictors, and outcomes of patient prosthesis mismatch in women undergoing TAVI for severe aortic stenosis: Insights from the WIN-TAVI registry.

Aortic Valve / diagnostic imaging Aortic Valve Stenosis / diagnostic imaging Female Heart Valve Prosthesis Heart Valve Prosthesis Implantation Humans Postoperative Complications Prevalence Registries Risk Factors Time Factors Transcatheter Aortic Valve Replacement / adverse effects Treatment Outcome
TAVI females outcomes patient-prosthesis mismatch

Journal

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139

Informations de publication

Date de publication:
15 02 2021
Historique:
received: 13 07 2019
revised: 05 08 2020
accepted: 08 08 2020
pubmed: 1 9 2020
medline: 25 9 2021
entrez: 1 9 2020
Statut: ppublish

Résumé

To evaluate the incidence, predictors and outcomes of female patients with patient-prosthesis mismatch (PPM) following transcatheter aortic valve intervention (TAVI) for severe aortic stenosis (AS). Female AS TAVI recipients have a significantly lower mortality than surgical aortic valve replacement (SAVR) recipients, which could be attributed to the potentially lower PPM rates. TAVI has been associated with lower rates of PPM compared to SAVR. PPM in females post TAVI has not been investigated to date. The WIN-TAVI (Women's INternational Transcatheter Aortic Valve Implantation) registry is a multicenter registry of women undergoing TAVR for severe symptomatic AS. Two hundred and fifty patients with detailed periprocedural and follow-up echocardiographic investigations were included in the WIN-TAVI echocardiographic sub-study. PPM was defined as per European guidelines stratified by the presence of obesity. The incidence of PPM in our population was 32.8%. Patients with PPM had significantly higher BMI (27.4 ± 6.1 vs. 25.2 ± 5.0, p = .002), smaller sized valves implanted (percentage of TAVI ≤23 mm 61% vs. 29.2%, PPM vs. no PPM, p < .001) and were more often treated with balloon expandable valves (48.3 vs. 32.5%, p < .001) rather than self expanding ones (26.3 vs. 52.8%, <.001). BMI (OR = 1.08; 95%CI 1.02-1.14, p = .011) and valve size ≤23 mm (OR = 3.00 95%CI 1.14-7.94, p = .027) were the only independent predictors of PPM. There was no significant interaction between valve size and valve type (p = .203). No significant differences were observed in 1-year mortality or major adverse cardiovascular events. PPM in females undergoing TAVI occurs in one third of patients. BMI and valve size ≤23 mm are independent predictors. Larger registries are required to determine the impact of PPM on future clinical outcomes.

Sections du résumé

OBJECTIVE
To evaluate the incidence, predictors and outcomes of female patients with patient-prosthesis mismatch (PPM) following transcatheter aortic valve intervention (TAVI) for severe aortic stenosis (AS).
BACKGROUND
Female AS TAVI recipients have a significantly lower mortality than surgical aortic valve replacement (SAVR) recipients, which could be attributed to the potentially lower PPM rates. TAVI has been associated with lower rates of PPM compared to SAVR. PPM in females post TAVI has not been investigated to date.
METHODS
The WIN-TAVI (Women's INternational Transcatheter Aortic Valve Implantation) registry is a multicenter registry of women undergoing TAVR for severe symptomatic AS. Two hundred and fifty patients with detailed periprocedural and follow-up echocardiographic investigations were included in the WIN-TAVI echocardiographic sub-study. PPM was defined as per European guidelines stratified by the presence of obesity.
RESULTS
The incidence of PPM in our population was 32.8%. Patients with PPM had significantly higher BMI (27.4 ± 6.1 vs. 25.2 ± 5.0, p = .002), smaller sized valves implanted (percentage of TAVI ≤23 mm 61% vs. 29.2%, PPM vs. no PPM, p < .001) and were more often treated with balloon expandable valves (48.3 vs. 32.5%, p < .001) rather than self expanding ones (26.3 vs. 52.8%, <.001). BMI (OR = 1.08; 95%CI 1.02-1.14, p = .011) and valve size ≤23 mm (OR = 3.00 95%CI 1.14-7.94, p = .027) were the only independent predictors of PPM. There was no significant interaction between valve size and valve type (p = .203). No significant differences were observed in 1-year mortality or major adverse cardiovascular events.
CONCLUSIONS
PPM in females undergoing TAVI occurs in one third of patients. BMI and valve size ≤23 mm are independent predictors. Larger registries are required to determine the impact of PPM on future clinical outcomes.

Identifiants

DOI: 10.1002/ccd.29227 PMID: 32865860
pubmed: 32865860
doi: 10.1002/ccd.29227
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

516-526

Informations de copyright

© 2020 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.

Références

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Auteurs

Vasileios F Panoulas (VF)

Department of cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Faculty of Medicine, Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, UK.
ORCID: 0000-0002-9894-9200

Jaya Chandrasekhar (J)

Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, Box 1030, USA.

Gherardo Busi (G)

Interventional cardiology unit, San Raffaele Scientific Institute, Milan, Italy.

Neil Ruparelia (N)

Department of cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
ORCID: 0000-0003-3968-2750

Zhongjie Zhang (Z)

Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, Box 1030, USA.

Julinda Mehilli (J)

Department of cardiology, Ludwig-Maximilians-University of Munich, Munich, Germany.
ORCID: 0000-0002-8750-5567

Samantha Sartori (S)

Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, Box 1030, USA.

Thierre Lefèvre (T)

Institut Cardiovasculaire Paris Sud, Hôpital privé Jacques cartier, Ramsay Générale de santé, Massy, France.

Patrizia Presbitero (P)

Department of Cardiology, IRCCS Humanitas Clinical and Research Centre, Milan, Italy.

Piera Capranzano (P)

Department of cardiology, University of Catania, Catania, Italy.
ORCID: 0000-0001-8434-7367

Didier Tchetche (D)

Department of cardiology, Clinique Pasteur, Toulouse, France.

Alessandro Iadanza (A)

Emodinamica, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Siena, Italy.
ORCID: 0000-0002-6435-1155

Gennaro Sardella (G)

Interventional cardiology unit, Policlinico "Umberto I, Rome, Italy.
ORCID: 0000-0002-9049-9479

Nicolas M Van Mieghem (NM)

Department of interventional cardiology, Erasmus Medical Center, Thoraxcenter, Rotterdam, The Netherlands.

Emanuele Meliga (E)

Interventional cardiology unit, Mauriziano Hospital, Turin, Italy.

Nicolas Dumonteil (N)

Department of cardiology, Clinique Pasteur, Toulouse, France.

Chiara Fraccaro (C)

Interventional cardiology unit, University of Padova, Padova, Italy.

Daniela Trabattoni (D)

Invasive Cardiology Unit 3, Centro Cardiologico Monzino, IRCCS, Milan, Italy.
ORCID: 0000-0002-6319-4119

Samin Sharma (S)

Department of cardiology, Mount Sinai Hospital, New York, New York, USA.
ORCID: 0000-0002-1888-0793

Maria-Cruz Ferrer-Gracia (MC)

Department of Cardiology, Interventional Cardiology Unit, Hospital Universitario Miguel Servet, Zaragoza, Spain.
ORCID: 0000-0002-3413-6024

Christoph K Naber (CK)

Department of cardiology, Contilia Heart and Vascular Centre, Elisabeth Krankenhaus, Essen, Germany.

Peter C Kievit (PC)

Department of cardiology, Radboud University Nijmegen Medical Center, Nijmegan,, The Netherlands.

Clayton Snyder (C)

Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, Box 1030, USA.

Nilesh Sutaria (N)

Department of cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.

Sayan Sen (S)

Department of cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Faculty of Medicine, Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, UK.

Iqbal S Malik (IS)

Department of cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Faculty of Medicine, Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, UK.

Marie-Claude Morice (MC)

Department of cardiology, Ludwig-Maximilians-University of Munich, Munich, Germany.

Petros Nihoyannopoulos (P)

Department of cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Faculty of Medicine, Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, UK.

Anna Sonia Petronio (AS)

Interventional cardiology unit, AOUP Cisanello, University Hospital, Pisa, Italy.

Roxana Mehran (R)

Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, Box 1030, USA.
ORCID: 0000-0002-5546-262X

Alaide Chieffo (A)

Interventional cardiology unit, San Raffaele Scientific Institute, Milan, Italy.

Ghada W Mikhail (GW)

Department of cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Faculty of Medicine, Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, UK.

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Classifications MeSH

questionsmedicales.fr › Système cardiovasculaire › Coeur › Valves cardiaques › Valve aortique › Prevalence, predictors, and outcomes of...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Obstacle à l'éjection ventriculaire › Sténose aortique › Prevalence, predictors, and outcomes of...
questionsmedicales.fr › Équipement et fournitures › Prothèses et implants › Prothèse valvulaire cardiaque › Prevalence, predictors, and outcomes of...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › Implantation de valve prothétique cardiaque › Prevalence, predictors, and outcomes of...
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questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › Implantation de valve prothétique cardiaque › Remplacement valvulaire aortique par cathéter › Prevalence, predictors, and outcomes of...
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