Valvular & structural heart diseaseCohort study
3-Year Outcomes of Balloon-Expandable Valves
- Retrospective cohort study
- propensity-score matched
- registry-based (STS/ACC TVT Registry with CMS linkage)
Authors' conclusion
Patients with small-prosthesis BEVs (20 mm) had identical 3-year survival as those with larger (≥23-mm) BEV valves.
Study context
- Population
- Patients receiving balloon-expandable valves in the TVT Registry with Medicare linkage
- Participants
- 316,091 patients · 8,100 matched pairs
- Exposure
- 20-mm vs ≥23-mm balloon-expandable valves
- 20-mm balloon-expandable valves (BEV)n = 8,100
- ≥23-mm BEVn = 8,100reference
- Outcome
- Mortality
- Follow-up
- 3 years
Main finding
As reported in the abstract
Hazard ratio
0.97
95% CI 0.90–1.05
By group
20-mm BEV vs ≥23-mm BEV
HR 0.97 (95% CI 0.90–1.05)
Observational data: associations, not effects.
Further findings
Discharge mean gradient
P < 0.0001
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| 3-year mortality, MG <10 mm Hg vs MG 10 to 30 mm Hg | 1.25 (1.22–1.27) | ||
| 0.512Hazard ratio (log scale) |
3-year mortality by prothesis-patient mismatch (PPM) category
- Measured severe PPM associated with increased mortality (33.5% vs 32.9% vs 32.1%)
- P < 0.0001
- Predicted no PPM associated with increased mortality (33.5% vs 31.1% vs 30%)
- P < 0.0001
Left ventricular ejection fraction (LVEF)
- Low mean gradient (MG) and severe measured PPM associated with lower LVEF
Original publication
3-Year Outcomes of Balloon-Expandable Valves. JACC Cardiovasc Interv. Published 21 August 2024. doi:10.1016/j.jcin.2024.06.001
Summarised from the published abstract; every number is checked against it