Valvular & structural heart diseaseCohort study
Assessment of the gradient gap after transcatheter aortic valve replacement (TAVR) with balloon and self-expandable valves: Analysis of a large patient cohort
- Analysis of a large patient cohort
- multivariable linear regression analysis
Authors' conclusion
echocardiographic gradients after TAVR consistently overestimate invasive values, especially with balloon-expandable valves, but without impacting short or mid-term mortality.
Study context
- Population
- Patients with severe aortic stenosis (AS) who underwent TAVR using either balloon-expandable (BEVs) or self-expanding valves (SEVs)TAVR patients included · BEVs 799 · SEVs 999
- Participants
- 1,798 patients
- Exposure
- BEV vs SEV
- BEVn = 799
- SEVn = 999
- Outcome
- Magnitude of discrepancy between peak transvalvular gradients measured by TTE and invasive hemodynamic assessment
- Follow-up
- Postprocedural
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Secondary outcomes
Postprocedural mean peak gradients by echocardiography · significantly higher in the BEV group
P < 0.001
Invasive mean peak gradients
P = 0.001
Mortality (in-hospital, 30-day, 1-year)
- No statistically significant differences in mortality between the BEV and SEV groups
- secondary endpoint
Predictors of gradient discrepancy (multivariable linear regression)
- Female sex, hypertension, preserved left ventricular function, small valve size, and small aortic annulus linked to greater differences between echocardiographic and invasive gradients
Original publication
Assessment of the gradient gap after TAVR with balloon and self-expandable valves: Analysis of a large patient cohort. Am Heart J. Published 17 March 2026. doi:10.1016/j.ahj.2026.107428
Summarised from the published abstract; every number is checked against it