Valvular & structural heart diseaseCohort study
Asymmetrical Expansion of Balloon-Expandable Transcatheter Aortic Valve Prostheses
- Prospective registry study
Authors' conclusion
Asymmetrical expansion of balloon-expandable THVs was associated with impaired hemodynamic valve performance but not with clinical outcomes.
Study context
- Population
- Patients undergoing transfemoral transcatheter aortic valve replacement (TAVR) for native severe AS with contemporary balloon-expandable transcatheter heart valves (THVs), February 2014 to June 2022
- Participants
- 1,216 patients
- Exposure
- TAVR asymmetry index
- Outcome
- Impaired hemodynamic valve performance (mean residual THV gradient ≥20 mm Hg and/or moderate or greater paravalvular regurgitation) on echocardiography
- Follow-up
- Before hospital discharge
Main finding
As reported in the abstract
Asymmetry index as predictor of impaired hemodynamic valve performance
AUC of asymmetry index
0.88 (95% CI: 0.84-0.92; P < 0.001)
Optimal threshold
>5.5% (sensitivity 77%, specificity 86%)
Patients above threshold
17%
Higher asymmetry index (continuous), adjusted OR
1.37 (95% CI: 1.29-1.46; P < 0.001)
Observational data: associations, not effects.
Further findings
All-cause mortality, high TAVR asymmetry index · median 376 days of follow-up
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| High asymmetry index | 1.00 (0.71–1.41) | P = 0.989 | |
| 0.512Hazard ratio (log scale) |
Original publication
Asymmetrical Expansion of Balloon-Expandable Transcatheter Aortic Valve Prostheses. JACC Cardiovasc Interv. Published 9 September 2024. doi:10.1016/j.jcin.2024.05.039
Summarised from the published abstract; every number is checked against it