The risk of prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) appears to be much smaller among Asian patients, according to new findings published in JACC: Cardiovascular Interventions.
“PPM is a condition in which the effective orifice area of a normally functioning implanted valve prosthesis is small relative to the patient’s body size,” wrote first author Hanbit Park, MD, of University of Ulsan College of Medicine in South Korea, and colleagues. “Given that the number of TAVR procedures is rapidly increasing worldwide, involving diverse racial and ethnic groups of patients, considerations concerning PPM are of particular relevance in Asian populations with unique anatomical features such as smaller annular dimensions or smaller valve implant size compared with Western populations.”
Park et al. examined data from more than 1,000 TAVR patients who were treated from January 2015 to November 2019. All patients received care at one of two U.S. facilities or a facility in South Korea. More than 80% of patients received a balloon-expandable valve.
The study’s authors believe their analysis to be the first to focus on the potential difference between PPM rates among Asian and non-Asian patients. Overall, the PPM rate was “significantly lower” among the Asian patient population (33.6%) than all other patients (54.5%). An especially big difference was seen in the rate of severe PPM among the two groups—it was 7.1% for Asian patients and 24.7% for all other patients.
Despite this finding, the group noted, Asian and non-Asian patients faced a similar risk of the study’s primary outcome, which was a composite of death, stroke or rehospitalization after one year.
“Considering the limited duration of clinical follow-up in our study, further large studies with extended (at least 3-5 years) follow-up are required to delineate the true long-term prognostic effect of PPM after TAVR,” the authors wrote.
The full study is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.