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Lookup NU author(s): Muntaser Omari, Sarah Lamb, Dr Rajiv Das, Dr Richard Edwards, Professor Azfar ZamanORCiD, Dr Mohammad Alkhalil
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 by the authors.Background and Objectives: Recent studies have focused on evaluating the hemodynamic results in patients undergoing transcatheter aortic valve implantation (TAVI) with small aortic annuli. There is limited data on the incidence, clinical characteristics, and mortality of prosthesis–patient mismatch (PPM) in patients undergoing TAVI with large aortic annuli. Materials and Methods: This is a retrospective analysis of consecutive patients with severe aortic stenosis and large annuli who underwent TAVI at a single UK center. PPM was defined according to the Valve Academic Research Consortium (VARC-3) criteria and identified using echocardiography within 4–6 weeks following TAVI. Measurements were analyzed by an experienced operator who was blinded to the type of valve platform and clinical outcomes. Results: A total of 447 patients were screened, of whom 353 patients were included in the analysis. The incidence of any PPM or severe PPM was 38% and 15% of patients, respectively. Patients with severe PPM were younger, had larger body surface area, and were more likely to receive a balloon-expandable valve (BEV). At a mean follow-up of 35 months, mortality was numerically higher in patients with severe PPM (46% vs. 36%, p = 0.20) but this did not reach statistical significance. Similar mortality rates were observed among patients with or without severe PPM in those who received SEV as well as BEV. There was a differential role of body surface area in mortality in patients who developed severe PPM versus non-severe PPM. Conclusions: Severe PPM was evident in patients with large aortic annuli undergoing TAVI, particularly those who received BEV. Nonetheless, severe PPM did not impact mortality rate at three-year follow-up. Longer-term follow-up may be required to assess the impact of severe PPM on mortality.
Author(s): Ali M, Omari M, Stewart D, Lamb S, Cartlidge T, Das R, Edwards R, Zaman A, Farag M, Alkhalil M
Publication type: Article
Publication status: Published
Journal: Medicina
Year: 2026
Volume: 62
Issue: 5
Online publication date: 06/05/2026
Acceptance date: 29/04/2026
Date deposited: 09/06/2026
ISSN (print): 1010-660X
ISSN (electronic): 1648-9144
Publisher: Multidisciplinary Digital Publishing Institute (MDPI)
URL: https://doi.org/10.3390/medicina62050892
DOI: 10.3390/medicina62050892
Data Access Statement: The data presented in this study are available on request from the corresponding author.
PubMed id: 42195145
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