Transcatheter Aortic Valve Replacement in Patients With a Small Annulus ― From the Japanese Nationwide Registry (J-TVT) ―
Kentaro Meguro, Hiraku Kumamaru, Shun Kohsaka, Takuya Hashimoto, Ryota Kakizaki, Tadashi Kitamura, Hideyuki Shimizu, Junya Ako
Abstract
BACKGROUND: The details and consequences of a small aortic annulus among transcatheter aortic valve replacement (TAVR) patients remain uncertain. This study investigated the short-term outcomes in patients with small annular size and compared the 30-day outcome between intra- and supra-annular devices, with similar outer casing diameter in this subgroup. METHODS AND RESULTS: [0.8-1.24], P=0.001) and higher mPG (14.0 mmHg [10.0-18.5] vs. 11.0 [7.0-14.0], P<0.001) compared with those receiving a 23-mm supra-annular device, although the incidence of paravalvular leakage (≥moderate) was similar (14.4% vs. 16.5%, P=0.69). CONCLUSIONS: Patients with a small annulus were associated with less hemodynamic improvement. A supra-annular device is associated with better echocardiographic improvement in patients with a small annulus, without increasing paravalvular leakage.