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Smaller implanted heart valves lead to inadequate blood flow, increase risks

Friday September 28, 2018 10:06 AM, News Network

Washington: A study published on Sunday in the Journal of the American College of Cardiology showed that many patients who underwent a transcatheter aortic valve replacement (TAVR) had too small implanted heart valves that lead to inadequate blood flow, thus increasing health risks.

The team led by University of Pennsylvania School of Medicine found that the risk of death and of heart failure readmissions were 19 percent and 12 percent higher, respectively, after one year as compared to patients without severe prosthesis-patient mismatch (PPM), Xinhua reported qouting the study's lead author Howard C. Herrmann, Professor of Cardiovascular Medicine and Surgery at Penn Medicine.

"Based on these findings, PPM is an important problem in this population, one that deserves greater awareness among operators. And being aware of it is the first step in trying to prevent it," said Herrmann said.

TAVR is an minimally invasive, catheter-based approach for the treatment of aortic stenosis, a narrowing of the heart's aortic valve. It has revolutionized valve replacement options for surgical (open-heart) valve replacement.

Researchers found 12 percent of 62,125 patients who received TAVRs in the United States between 2014 and 2017 experienced severe PPM, while 25 percent had moderate PPM.

PPM is a mismatch of the blood flow dynamics of the prosthetic valve and the amount of blood the heart needs to pump to the rest of the patient's body, according to the researchers.

The researchers identified multiple predictors of PPM, including patients with a smaller valve prosthesis, those who had a larger body surface area, or patients who are female or younger.

"Severe PPM occurs frequently after TAVR procedures, and it results in worse outcomes, even after a short period of one year," Herrmann said.

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