Impact of Small Valve Size on 1-Year Outcomes After Transcatheter Aortic Valve Implantation in Women (from the WIN-TAVI Registry)

Carlo A. Pivato, Davide Cao, Alessandro Spirito, Samantha Sartori, Johny Nicolas, Mauro Chiarito, Clayton Snyder, Julinda Mehilli, Thierry Lefèvre, Giulio G. Stefanini, Patrizia Presbitero, Piera Capranzano, Didier Tchetche, Alessandro Iadanza, Birgit Vogel, Gennaro Sardella, Nicolas M. Van Mieghem, Matteo Nardin, Anne H. Tavenier, Emanuele MeligaNicholas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Samin Sharma, Maria Cruz Ferrer, Christoph Naber, Peter Kievit, Usman Baber, Anna S. Petronio, Marie C. Morice, Alaide Chieffo, George Dangas, Roxana Mehran

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Although most patients with small aortic annulus are women, there is paucity of data on the prognostic impact of small aortic prosthesis in women who underwent transcatheter aortic valve implantation (TAVI). Therefore, we aimed to evaluate the impact of small valve size on 1-year clinical outcomes after TAVI in women. The Women's INternational Transcatheter Aortic Valve Implantation is an all-women registry evaluating patients with severe aortic stenosis who underwent TAVI. Based on the size of the aortic bioprosthesis implanted, women were stratified into small (≤23 mm) and nonsmall (>23 mm) valve. The primary efficacy endpoint was the Valve Academic Research Consortium-2 composite of all-cause death, stroke, myocardial infarction, hospitalization for valve-related symptoms or heart failure or valve-related dysfunction at 1-year follow-up. Of 934 women who underwent TAVI, 388 (41.5%) received a small valve. Women with a small valve size had a lower body mass index, lower surgical risk scores, were less likely to suffer from atrial fibrillation, less often required postdilation and had a lower rate of residual aortic regurgitation grade ≥2. The occurrence of the Valve Academic Research Consortium-2 efficacy endpoint was similar between women treated with small and nonsmall valve (16.0% vs 16.3%, p = 0.881; adjusted hazard ratio 1.34, 95% confidence interval 0.90 to 2.00). Likewise, there were no significant differences in the occurrence of other secondary endpoints after multivariable adjustment. In conclusion, women with severe aortic stenosis who underwent TAVI with the implantation of a small valve bioprosthesis had similar 1-year outcomes as those receiving a nonsmall bioprosthesis.

Original languageEnglish
Pages (from-to)73-80
Number of pages8
JournalAmerican Journal of Cardiology
Volume172
DOIs
StatePublished - 1 Jun 2022

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