Impact of Measured and Predicted Patient–Prosthesis Mismatch on Quality of Life Following Transcatheter Aortic Valve Implantation
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background While patient-prosthesis mismatch (PPM) after transcatheter aortic valve implantation (TAVI) has not been associated with increased mortality, its impact on quality of life (QOL) remains unclear. Aims To evaluate the relationship between predicted (PPM P ) and measured (PPM M ) PPM and QoL, assessed using New York Heart Association (NYHA) class and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores at 30 days and 1-year post-TAVI. Methods We retrospectively analyzed 3,013 patients undergoing TAVI (2012-2022) within a large healthcare system. Patients were stratified by effective orifice area indexed to body surface area (EOAi) into no (EOAi >0.85 cm 2 /m 2 ), moderate (EOAi >0.65 cm 2 /m 2 or ≤0.85 cm 2 /m 2 ), or severe (EOAi ≤0.65 cm 2 /m 2 ) PPM, with lower cut-offs for obese patients (BMI ≥ 30 kg/m 2 ). Results The median age was 80.0 [73.0;86.0] years, and 55.6% were female with a median Society of Thoracic Surgery risk score of 4.70% [2.66;7.64]. Overall, TAVI led to significant improvements in NYHA and KCCQ scores at 30 days and 1 year. Neither severe PPM P nor severe PPM M was associated with inferior QoL outcomes improvement (all p>0.05). Conclusion In this large cohort, TAVI yielded substantial and durable QoL gains, regardless of PPM severity or valve type. These findings suggest that moderate or severe PPM does not diminish functional recovery and should not be a primary determinant in valve selection or procedural strategy at 1-year.
Source: Structural Heart
Authors: Karim Al-Azizi, Mohamad Bader Abo Hajar, Taylor Pickering, Ghadi Moubarak, Cody W. Dorton, Kyle A. McCullough, Jonathan Ladner, Maya Elias, Colleen Parro, Shelby L. McCoy, Uzair Saeed, Tsung-Wei Ma, Sarah Hale, Swapnil Gupta, Katherine B. Harrington, Justin M. Schaffer, Asim Mohiuddin, William T. Brinkman, Amro Alsaid, Janaki Manne, Ralph Matar, Prajakta Phatak, Sibi Thomas, Zuyue Wang, Robert Stoler, Subhash Banerjee, Yashasvi Chugh, Timothy Mixon, Robert J. Widmer, Angel Caldera, Jose Condado Contreras, Anita Krueger, William Gray, Julius Ejiofor, Imran Baig, Srinivasa Potluri, J. Michael DiMaio, Molly Szerlip, Michael J. Mack
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,340
OpenAlex ID: W4416135652