Valvular & structural heart diseaseCohort study
Prosthesis-Patient Mismatch in Young and Low-Risk Patients After Newer Generation Balloon-Expandable Transcatheter Aortic Valve Replacement
- Retrospective cohort study
- single-centre
Authors' conclusion
PPM is associated with worse clinical outcomes in young and low-risk patients with AS after TAVR, even with newer generation balloon-expandable valves.
Study context
- Population
- Patients <75 years with STS score <4% and severe native aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) with newer generation balloon-expandable valves, 2015–2022
- Participants
- 512 patients
- Exposure
- Prosthesis-patient mismatch (PPM) vs no PPM after TAVR
- PPMn = 200
- Outcome
- All-cause and CV mortality or HF hospitalization
- Follow-up
- Median 1,034 days (Q1-Q3: 550-1,567 days)
Main finding
As reported in the abstract
median 1,034 days
PPM vs non-PPMHazard ratio (95% CI)P value
all-cause mortality
2.55(1.3–5.0)
P = 0.007CV mortality
2.81(1.1–7.5)
P = 0.04HF hospitalization
4.43(2.0–9.9)
P < 0.001Observational data: associations, not effects.
Further findings
Incidence of PPM
- Any PPM (200 of 512)
- 39.0%
- Moderate PPM (162 of 512)
- 31.6%
- Severe PPM (38 of 512)
- 7.4%
Independent predictors of PPM
- Younger age, female sex, larger body surface area, no balloon postdilation, smaller annular area
Original publication
Prosthesis-Patient Mismatch in Young and Low-Risk Patients After Newer Generation Balloon-Expandable Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. Published 23 June 2025. doi:10.1016/j.jcin.2025.05.003
Summarised from the published abstract; every number is checked against it