The Particulars: Prosthesis-patient mismatch (PPM) appears to affect survival, according to several studies, and has been associated with morbidity and mortality among patients who undergo transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). Predictors of PPM in patients undergoing TAVR have not been well defined.
Data Breakdown: Investigators analyzed predictors of PPM in patients randomized to TAVR or SAVR. After multivariate analyses, independent predictors of PPM in TAVR recipients included younger age, larger body surface area, smaller aortic annulus diameter, and smaller cover index. Predictors of PPM in the SAVR groups included larger body surface area, smaller aortic annulus diameter, and renal dysfunction.
Take Home Pearl: Larger body size and smaller aortic annulus diameter appear to be risk factors for PPM in both SAVR and TAVR procedures.