Patients who underwent a minimally invasive, catheter-based approach to replace the aortic valve experienced inadequate blood flow because the prosthetic valves were too small, finds a research. Transcatheter aortic valve replacement (TAVR) allows physicians to replace the aortic valve without the need to remove the old, damaged one. The team, led by University of Pennsylvania, found that a high number of people experienced severe and moderate cases of prosthesis-patient mismatch (PPM) that affected blood flow that the heart needs to pump to the rest of the patient’s body, thus increasing risk of heart failure and death. The risk of death and of heart failure re-admissions was 19 percent and 12 percent higher, respectively, after one year as compared to patients without severe PPM. “This is an important contemporary snapshot of what’s happening in the real world with commercial TAVR procedures,” said lead author Howard C. Herrmann, Professor at the varsity.
“Based on these findings, PPM is an important problem in this population, one that deserves greater awareness among operators. And being aware of it is the first step in trying to prevent it,” he added. In the study, published in the Journal of the American College of Cardiology, the team found that 12 percent of 62,125 patients, who received TAVRs in the US between 2014 and 2017, experienced severe PPM while 25 percent had moderate PPM. They identified multiple predictors of PPM, including patients with smaller valve prosthesis, those who had a larger body surface area, or patients who are female or younger. “Severe PPM occurs frequently after TAVR procedures, and it results in worse outcomes, even after a short period of one year,” Herrmann said. – Business Standard