Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry
Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-10-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/20/6117 |
| _version_ | 1797431519988416512 |
|---|---|
| author | Pierre Deharo Lionel Leroux Alexis Theron Jérome Ferrara Antoine Vaillier Nicolas Jaussaud Alizée Porto Pierre Morera Vlad Gariboldi Bernard Iung Thierry Lefevre Philippe Commeau Margaux Gouysse Florence du Chayla Nicolas Glatt Guillaume Cayla Herve Le Breton Hakim Benamer Sylvain Beurtheret Jean Philippe Verhoye Helene Eltchaninoff Martine Gilard Jean Philippe Collet Nicolas Dumonteil Frederic Collart Thomas Modine Thomas Cuisset |
| author_facet | Pierre Deharo Lionel Leroux Alexis Theron Jérome Ferrara Antoine Vaillier Nicolas Jaussaud Alizée Porto Pierre Morera Vlad Gariboldi Bernard Iung Thierry Lefevre Philippe Commeau Margaux Gouysse Florence du Chayla Nicolas Glatt Guillaume Cayla Herve Le Breton Hakim Benamer Sylvain Beurtheret Jean Philippe Verhoye Helene Eltchaninoff Martine Gilard Jean Philippe Collet Nicolas Dumonteil Frederic Collart Thomas Modine Thomas Cuisset |
| author_sort | Pierre Deharo |
| collection | DOAJ |
| description | Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusions: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥ 2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up. |
| first_indexed | 2024-03-09T09:46:14Z |
| format | Article |
| id | doaj.art-deade19e839144388cee2128128a3c24 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T09:46:14Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-deade19e839144388cee2128128a3c242023-12-02T00:33:42ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011120611710.3390/jcm11206117Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI RegistryPierre Deharo0Lionel Leroux1Alexis Theron2Jérome Ferrara3Antoine Vaillier4Nicolas Jaussaud5Alizée Porto6Pierre Morera7Vlad Gariboldi8Bernard Iung9Thierry Lefevre10Philippe Commeau11Margaux Gouysse12Florence du Chayla13Nicolas Glatt14Guillaume Cayla15Herve Le Breton16Hakim Benamer17Sylvain Beurtheret18Jean Philippe Verhoye19Helene Eltchaninoff20Martine Gilard21Jean Philippe Collet22Nicolas Dumonteil23Frederic Collart24Thomas Modine25Thomas Cuisset26Département de Cardiologie, CHU Timone, 13385 Marseille, FranceDépartement de Cardiologie, CHU Bordeaux, 33075 Bordeaux, FranceDépartement de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, FranceDépartement de Cardiologie, CHU Timone, 13385 Marseille, FranceDépartement de Cardiologie, CHU Timone, 13385 Marseille, FranceDépartement de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, FranceDépartement de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, FranceDépartement de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, FranceINSERM, Inra, C2VN, Aix Marseille La Timone University, 13005 Marseille, FranceAP-HP, Cardiology Department, Bichat Hospital, Université Paris Cité, INSERM 1148, 46 rue Henri Huchard, 75018 Paris, FranceHopital Privé Jacques Cartier, 6 Av. Noyer Lambert, 91300 Massy, FranceCardiologie Interventionnelle, Polyclinique Les Fleurs, Groupe ELSAN, 83190 Ollioules, FranceClinityx, 78620 Acheres, FranceClinityx, 78620 Acheres, FranceClinityx, 78620 Acheres, FranceDepartment of Cardiology, CHU Nîmes, 30029 Nimes, FranceService de Cardiologie, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, 35033 Rennes, FranceHopital Privé Jacques Cartier, 6 Av. Noyer Lambert, 91300 Massy, FranceSaint-Joseph Hospital, 13000 Marseille, FranceRennes University Hospital, 35033 Rennes, FranceDepartment of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, 76000 Rouen, FranceDepartment of Cardiology, CHRU Brest, 29200 Brest, FranceDepartment of Cardiology, Sorbonne Université, INSERM UMRS_1166, Pitié Salpêtrière (AP-HP), 75000 Paris, FranceGroupe CardioVasculaire Interventionnel, Clinique Pasteur, 31300 Toulouse, FranceINSERM, Inra, C2VN, Aix Marseille La Timone University, 13005 Marseille, FranceDépartement de Cardiologie, CHU Bordeaux, 33075 Bordeaux, FranceDépartement de Cardiologie, CHU Timone, 13385 Marseille, FranceBackground: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusions: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥ 2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up.https://www.mdpi.com/2077-0383/11/20/6117TAVImismatchparavalvular leak |
| spellingShingle | Pierre Deharo Lionel Leroux Alexis Theron Jérome Ferrara Antoine Vaillier Nicolas Jaussaud Alizée Porto Pierre Morera Vlad Gariboldi Bernard Iung Thierry Lefevre Philippe Commeau Margaux Gouysse Florence du Chayla Nicolas Glatt Guillaume Cayla Herve Le Breton Hakim Benamer Sylvain Beurtheret Jean Philippe Verhoye Helene Eltchaninoff Martine Gilard Jean Philippe Collet Nicolas Dumonteil Frederic Collart Thomas Modine Thomas Cuisset Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry Journal of Clinical Medicine TAVI mismatch paravalvular leak |
| title | Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry |
| title_full | Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry |
| title_fullStr | Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry |
| title_full_unstemmed | Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry |
| title_short | Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry |
| title_sort | long term prognosis value of paravalvular leak and patient prosthesis mismatch following transcatheter aortic valve implantation insight from the france tavi registry |
| topic | TAVI mismatch paravalvular leak |
| url | https://www.mdpi.com/2077-0383/11/20/6117 |
| work_keys_str_mv | AT pierredeharo longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT lionelleroux longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT alexistheron longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT jeromeferrara longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT antoinevaillier longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT nicolasjaussaud longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT alizeeporto longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT pierremorera longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT vladgariboldi longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT bernardiung longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT thierrylefevre longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT philippecommeau longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT margauxgouysse longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT florenceduchayla longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT nicolasglatt longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT guillaumecayla longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT hervelebreton longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT hakimbenamer longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT sylvainbeurtheret longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT jeanphilippeverhoye longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT heleneeltchaninoff longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT martinegilard longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT jeanphilippecollet longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT nicolasdumonteil longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT fredericcollart longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT thomasmodine longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry AT thomascuisset longtermprognosisvalueofparavalvularleakandpatientprosthesismismatchfollowingtranscatheteraorticvalveimplantationinsightfromthefrancetaviregistry |