Measured Versus Predicted Prosthesis–Patient Mismatch after TAVR in Sievers Type 1 BAV: Incidence, Determinants, and Outcomes From the AD-HOC Registry
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Le résumé fourni par la source
BACKGROUND: Evidence regarding prosthesis–patient mismatch (PPM), measured (mPPM), and predicted (pPPM), after transcatheter aortic valve replacement in bicuspid aortic valve stenosis remains limited. This study sought to evaluate the incidence, predictors, and prognostic implications of mPPM and pPPM in patients with Sievers type 1 bicuspid aortic valve undergoing transcatheter aortic valve replacement. METHODS: The AD-HOC registry is a retrospective, multicenter study including 781 patients with severe aortic stenosis and bicuspid aortic valve treated with transcatheter aortic valve replacement between 2016 and 2023 across 24 centers. PPM was defined according to Valve Academic Research Consortium-3 criteria. The primary outcome was all-cause mortality. RESULTS: Moderate-to-severe mPPM was more frequent than pPPM (22% versus 8%; P <0.001). Balloon-expandable valves were independently associated with both mPPM and pPPM, while smaller valve size and supra-annular sizing predicted only pPPM. During a mean follow-up of 621±470 days, neither mPPM nor pPPM was associated with mortality in the overall cohort. Among patients with a small annulus (≤430 mm 2 ; n=145), pPPM occurrence was significantly higher (19% versus 5.5%; P <0.001) and was associated with increased all-cause mortality, but not with cardiovascular mortality. CONCLUSIONS: In patients with Sievers type 1 bicuspid aortic valve undergoing transcatheter aortic valve replacement, pPPM occurred less frequently than mPPM and was predominantly driven by anatomic characteristics and sizing strategies. Although pPPM was associated with increased all-cause mortality among patients with small annuli, this association did not extend to cardiovascular mortality and should be considered hypothesis-generating. Further prospective investigations are warranted to better delineate the impact of anatomic constraints on clinical outcomes in this anatomically challenging subset.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Measured Versus Predicted Prosthesis–Patient Mismatch after TAVR in Sievers Type 1 BAV: Incidence, Determinants, and Outcomes From the AD-HOC Registry
- Date Crossref
- 01/07/2026
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Fondazione Poliambulanza Istituto Ospedaliero pays non établi dans la noticeÉtablissement de santé
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Clinique Pasteur pays non établi dans la noticeÉtablissement de santé
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University of the Sacred Heart Department of Cardiovascular and Pulmonary Sciences pays non établi dans la noticeUniversité ou école supérieure
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IRCCS Humanitas Research Hospital Cardio Center pays non établi dans la noticeÉtablissement de santé
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Copenhagen University Hospital Rigshospitalet pays non établi dans la noticeÉtablissement de santé
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Rigshospitalet pays non établi dans la noticeÉtablissement de santé
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Policlinico Universitario di Catania pays non établi dans la noticeÉtablissement de santé
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Azienda Ospedaliera Universitaria Pisana pays non établi dans la noticeÉtablissement de santé
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Leeds Teaching Hospitals NHS Trust Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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Cedars-Sinai Smidt Heart Institute Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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University Hospital Galway pays non établi dans la noticeÉtablissement de santé
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Vita-Salute San Raffaele University pays non établi dans la noticeUniversité ou école supérieure
Fondazione Poliambulanza Istituto Ospedaliero, Clinique Pasteur et Department of Cardiovascular and Pulmonary Sciences — University of the Sacred Heart, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.