Prosthesis-patient mismatch is an independent predictor of congestive heart failure after transcatheter aortic valve replacement.

Summary Background Little is known about the effect of prosthesis-patient mismatch (PPM) on outcomes after transcatheter aortic valve replacement. We reported previously an increased risk of PPM with the SAPIEN 3 transcatheter heart valve (S3-THV). Aims To investigate the association of PPM with 1-year outcomes in patients with severe aortic stenosis (AS) implanted with S3-THV. Methods Moderate PPM was defined by an indexed effective orifice area (iEOA) ≤ 0.85 cm2/m2, and severe PPM by an iEOA Results A total of 208 consecutive patients were included between 2016 and 2018. Male sex was prevalent (53.8%), mean age was 81.9 ± 6.2 years, mean EuroSCORE II was 4.35 ± 3.37, mean LVEF was 57.9 ± 13%. Moderate and severe PPM were observed in 69 (33.2%) and 10 (4.8%) patients. Patients with PPM were younger (80.4 ± 7 vs 82.8 ± 5.41 years; P = 0.006), had a larger BSA (1.84 ± 0.19 vs 1.77 ± 0.19 m2; P = 0.01), a lower iEOA (0.73 ± 0.08 vs 1.11 ± 0.22 cm2/m2; P 100, 95%CI > 100 to > 1000; P Conclusions PPM after S3-THV implantation is strongly associated with CHF at 1 year, but is not correlated with overall mortality.