TAVR patients with annulus-to-prosthesis ratio >0.9 showed improved LV function at 1 year, while those ≤0.9 did not, despite similar clinical outcomes.
Does an annulus-to-prosthesis size ratio >0.9 improve reverse cardiac remodeling and clinical outcomes in patients undergoing TAVR compared to a ratio ≤0.9?
An annulus-to-prosthesis size ratio >0.9 during TAVR is associated with improved LV function at 1 year, though this did not translate to a significant difference in heart failure hospitalizations.
Absolute Event Rate: 0% vs 0%
Abstract Background and Aim Aortic annulus size and morphology has been associated with periprocedural outcomes in patients treated with transcatheter aortic valve replacement (TAVR). We aim to assess the impact of the annulus-to-prosthesis size ratio on echocardiographic and clinical features 1-year after the procedure. Methods Retrospective analysis of a prospective cohort of patients with severe AS who underwent TAVR at a tertiary care centre between 2017 and 2023. Patients were divided into two groups: patients with an annulus-to-prosthesis ratio £0.9 (group 1, n=336), and those with a ratio 0.9 (group 2, n=539). Baseline and 1-year follow-up echocardiographic anatomical and functional parameters were compared, and clinical outcomes during follow-up were analyzed. Results A total of 875 patients were included. The mean age was 82 years (5.8) and the mean EuroSCORE II was 4.8 (5.5). At 1-year follow-up, both groups showed a significant reduction in left ventricular (LV) volume and mass index. Likewise, there were significant improvements regarding left atrial function and right ventricular parameters in both groups. However, LV function (LVEF and GLS) only improved in patients with a ratio 0.9. Effective area and transvalvular gradients did not differ between groups (Figure 1). As regards to clinical outcomes, no significant differences were found in heart failure hospitalizations during follow-up between both groups of patients (15% vs 19%, p=0.201). Conclusions Regardless of the annulus-to-prosthesis size ratio, patients treated with TAVR experienced significant reverse remodeling in LA and RV function parameters. Conversely, an annulus-to-prosthesis size ratio lower than 0.9 was associated with lack of LV function improvement. These differences were not associated with significant differences regarding clinical outcomes during follow-up.
Florez et al. (Sat,) reported a other. TAVR patients with annulus-to-prosthesis ratio >0.9 showed improved LV function at 1 year, while those ≤0.9 did not, despite similar clinical outcomes.