Prosthesis-Patient Mismatch and Patient-Centered Outcomes After TAVR.

What was studied

This study looked at people who got a new aortic valve through a thin tube. Sometimes the new valve is a poor fit for the patient. The team asked if a poor fit changed how people felt. They used data from an earlier trial that compared valve types. This look at the data was not planned when the trial began. People filled in a health form for up to 3 years. Good health meant a form score of 75 or more. It also meant no drop of more than 10 points from the start.

What they found

The study had 662 people. Of these, 184 had a moderate poor fit, and 69 had a severe one. Deaths at 1 and 3 years did not differ by fit. Health scores were alike across groups up to 1 year. At 3 years, scores were lower with a severe poor fit. The middle scores were 71.1 versus 83.9 with no poor fit. At 3 years, fewer people with a severe poor fit were alive and well. This link was no longer clear after allowing for a leaky mitral valve. That leak was measured 30 days after the valve was put in.

What it means for patients

Among survivors, a severe poor fit was linked to worse health at 3 years. The authors think a leaky mitral valve may play a part in this. They say the results raise ideas to test, not firm answers.

Why it is not certain yet

The team looked at the data after the trial, as a side question. So the authors say the results only raise ideas for new studies. It shows links, not proof that a poor fit causes worse health. The link was weaker and not clear after allowing for the mitral leak.

Source

Prosthesis-Patient Mismatch and Patient-Centered Outcomes After TAVR.

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