eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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vol. 19
Original paper

Hemodynamic parameters of aortic valve prostheses – KRAK-AS registry analysis

Małgorzata Pińska
1, 2
Danuta Sorysz
3, 4
Magdalena Frączek-Jucha
1, 2
Maciej Stąpór
2, 5, 6
Karolina Golińska-Grzybała
2, 6
Jadwiga Nessler
1, 2
Andrzej Gackowski
1, 2, 4

Department of Coronary Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
The John Paul II Hospital, Krakow, Poland
Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
Noninvasive Cardiovascular Laboratory, The John Paul II Hospital, Krakow, Poland
Adv Interv Cardiol 2023; 19, 2 (72): 152–157
Online publish date: 2023/06/30
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The treatment of choice for aortic stenosis is a valve replacement. Some patients have post-procedural increased pressure gradient on the implanted prosthesis because of patient-prosthesis mismatch (PPM), known to adversely influence prognosis. The PPM risk should be initially predicted and effort made to avoid this complication, specifically in large body size patients.

To assess the frequency of PPM taking into account the valvular prosthesis type in a real-life population of consecutive patients included in the Krakow aortic stenosis registry.

Material and methods:
The KRAK-AS registry was conducted in July-October 2016. Patients were assessed before and after valve surgery and during the 3-year follow-up. Patients who underwent aortic valve intervention were clinically and echocardiographically evaluated within a month after surgery and divided into groups depending on the implanted prosthesis type. Analysis of patients with a smaller (< 23 mm) and larger than median (≥ 23 mm) valve diameter was performed.

The valve implantation was performed in 229 patients (42 mechanical, 139 biological, 48 transcatheter). No differences between patient groups compared by PPM occurrence was seen at baseline. Median age was 70 years; 55.5% were men. At least moderate PPM (iEOA ≤ 0.85 cm2/m2) was observed in 40% of mechanical valves, 33% of biological valves, and was significantly less frequent (10%) in patients after transcatheter valve implantation, p = 0.0001. Severe PPM (iEOA < 0.65 cm2/m2) was found in 17.6% of mechanical valve PPM patients, 4.3% of biological ones, and no patients after transcatheter procedure.

PPM is a frequent phenomenon in the real-life population of patients undergoing surgical aortic valve replacement, being significantly less frequent in the case of a transcatheter procedure.


aortic stenosis, prosthesis failure, aortic valve, echocardiography

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