Mismatch na TAVR

Prosthesis-Patient Mismatch Following Transcatheter Aortic Valve Replacement With Supra-Annular and Intra-Annular Prostheses

https://doi.org/10.1016/j.jcin.2019.07.027

Auto expandidas:

Expandidas por balão:

Conclusions

SEV ( self-expandable valves ) were associated with a lower frequency of PPM compared with BEV ( balloon-expandable valves ) irrespective of annulus area. The difference was mainly driven by larger patients with BSA >1.83 m2.

.

Por que as auto expandidas geram menos gradiente e mismatch?

Comparada à expandida por balão:

Hipótese:

Como a maioria dos pacientes são idosos com septo sigmóide, uma prótese que age mais profundamente na via de saída pode ajudar no gradiente pré valvar.

.