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Volume 62
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10.3390/medicina62050892
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Article

Incidence, Clinical Characteristics and Outcomes of Severe Prosthesis–Patient Mismatch in Patients Undergoing TAVI with Large Aortic Annuli

by
Mohamed Ali
1,
Muntaser Omari
1,2,
Debbie Stewart
1,
Sarah Lamb
1,
Timothy Cartlidge
1,
Rajiv Das
1,
Richard Edwards
1,
Azfar Zaman
1,
Mohamed Farag
1 and
Mohammad Alkhalil
1,2,*
1
Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK
2
Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK
*
Author to whom correspondence should be addressed.
Medicina 2026, 62(5), 892; https://doi.org/10.3390/medicina62050892
Submission received: 5 February 2026 / Revised: 27 April 2026 / Accepted: 29 April 2026 / Published: 6 May 2026
(This article belongs to the Special Issue New Insights into Coronary Artery Bypass)
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Abstract

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.
Keywords: aortic stenosis; TAVI; large annulus; prosthesis–patient mismatch; mortality aortic stenosis; TAVI; large annulus; prosthesis–patient mismatch; mortality

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MDPI and ACS Style

Ali, M.; Omari, M.; Stewart, D.; Lamb, S.; Cartlidge, T.; Das, R.; Edwards, R.; Zaman, A.; Farag, M.; Alkhalil, M. Incidence, Clinical Characteristics and Outcomes of Severe Prosthesis–Patient Mismatch in Patients Undergoing TAVI with Large Aortic Annuli. Medicina 2026, 62, 892. https://doi.org/10.3390/medicina62050892

AMA Style

Ali M, Omari M, Stewart D, Lamb S, Cartlidge T, Das R, Edwards R, Zaman A, Farag M, Alkhalil M. Incidence, Clinical Characteristics and Outcomes of Severe Prosthesis–Patient Mismatch in Patients Undergoing TAVI with Large Aortic Annuli. Medicina. 2026; 62(5):892. https://doi.org/10.3390/medicina62050892

Chicago/Turabian Style

Ali, Mohamed, Muntaser Omari, Debbie Stewart, Sarah Lamb, Timothy Cartlidge, Rajiv Das, Richard Edwards, Azfar Zaman, Mohamed Farag, and Mohammad Alkhalil. 2026. "Incidence, Clinical Characteristics and Outcomes of Severe Prosthesis–Patient Mismatch in Patients Undergoing TAVI with Large Aortic Annuli" Medicina 62, no. 5: 892. https://doi.org/10.3390/medicina62050892

APA Style

Ali, M., Omari, M., Stewart, D., Lamb, S., Cartlidge, T., Das, R., Edwards, R., Zaman, A., Farag, M., & Alkhalil, M. (2026). Incidence, Clinical Characteristics and Outcomes of Severe Prosthesis–Patient Mismatch in Patients Undergoing TAVI with Large Aortic Annuli. Medicina, 62(5), 892. https://doi.org/10.3390/medicina62050892

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