Valvular & structural heart disease
Implantation of contemporary transcatheter aortic valves in small aortic annuli: the international multicentre TAVI-SMALL 2 registry
Authors' conclusion
In small aortic annuli, implantation of SAV and SEV was associated with a more favourable forward haemodynamic profile than after IAV and BEV implantation, respectively. More than mild PVL was more common after SEV than BEV implantation.
Study context
- Population
- Severe AS with small annuli (annular perimeter <72 mm or area <400 mm²) treated with transfemoral TAVI, 2011–2020
- Participants
- 1,378 participants
- Exposure
- SEV vs balloon-expandable valves (BEV) and SAV vs intra-annular valves (IAV) transcatheter aortic valves
- SEVn = 1,092
- BEVn = 286reference
- SAVn = 920
- IAVn = 458reference
- Outcome
- Predischarge mean aortic gradient and incidence of severe PPM
- Follow-up
- Predischarge
Methodological detailsinternational, multicentre, 16 high-volume centres, inverse probability of treatment weighting (IPTW)
- International
- Multicentre
- 16 high-volume centres
- Inverse probability of treatment weighting (IPTW)
Main finding
As reported in the abstract
Predischarge mean aortic gradient; severe PPM
Predischarge mean aortic gradient; severe PPM SEV 8.0 ± 4.1 · BEV 13.6 ± 4.7 · SAV 7.8 ± 3.9 · IAV 12.0 ± 5.1
Severe PPM
P = 0.007
- SAV vs IAV: P < 0.001 — mean aortic gradient
- SEV vs BEV: P < 0.001 — mean aortic gradient
- BEV vs SEV: P = 0.041 — severe prosthesis-patient mismatch (PPM)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | SEV | BEV | P value |
|---|---|---|---|
| More than mild PVLSEV vs BEV | 11.6% | 2.6% | P < 0.001 |
Original publication
Implantation of contemporary transcatheter aortic valves in small aortic annuli: the international multicentre TAVI-SMALL 2 registry. EuroIntervention. Published 19 June 2023. doi:10.
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