Severe patient prosthesis mismatch (PPM) is not associated with a lower quality of life (QOL) at 1 year, compared with no PPM, in patients who undergo transcatheter aortic valve implantation (TAVI), a new analysis of patient data shows. The study, presented in a Late-Breaking Clinical Science session at Cardiovascular Research Technologies (CRT) 2025 on Monday, evaluated the impacts of measured PPM (pPPM) and predicted PPM (pPPM) on QOL in patients who underwent TAVI at a large Healthcare System. Karim Al-Azizi, MD, from the Heart Hospital, Baylor Scott & White Medical Center - Frisco, Texas, presented the study. He noted that multiple studies have shown no association between prosthesis-patient mismatch (PPM) and long-term mortality after transcatheter aortic valve implantation (TAVI), but whether PPM affects quality-of-life (QOL) after TAVI remains unknown. Study details Dr. Al-Azizi and colleagues performed a retrospective analysis of 3,013 patients (mean age 80 years, 55.6% male) who underwent TAVI at a large Healthcare System between 2017 and 2022. Effective orifice area indexed to body surface area (EOAi) was measured at discharge using the continuity equation. EOAi was predicted according to the published predictive tables for each model and size of the valve, he said. The primary endpoint was change in QOL as measured by New York Heart Association (NYHA) and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores at 1-year follow-up. The incidence of severe PPM was markedly lower when defined by predicted vs. measured EOAi (0.80% vs. 6.27%, P < 0.001), said Dr. Al-Azizi, adding that the median baseline KCCQ was 57.1 [41.4;72.9] and 63.1% of patients had a NYHA score ≥ 3 at baseline. Thirty-day QOL metrics did not differ between patients without PPM and those with severe PPMm for either NYHA (≥3: 14.57% vs. 20.48%, p= 0.111) or KCCQ (77.1 [61.4;87.1] vs. 74.3 [61.4;86.8], p= 0.26). Similarly, there were no differences in QOL scores for severe PPMp in NYHA (≥3: 14.98% vs. 21.06%, p= 0.494) or KCCQ (77.1 [61.4;87.1] vs. 74.3 [65.7;88.6], p= 0.86), he said. Furthermore, at 1-year the metrics did not differ between patients without PPM and those with severe PPMm for NYHA (≥3: 11.68% vs. 16.05%, p= 0.257) or KCCQ (81.4 [67.1;90.0] vs. 81.4 [70.0;88.2], p= 0.94), with the same true for when using PPMp against NYHA (≥3: 12.55% vs. 6.67%, p= 0.766) or KCCQ (81.4 [67.1;90.0] vs. 90.0 [71.4;92.9], p= 0.1). Dr. Al-Azizi added that there was also no difference in the change in KCCQ at 1 year compared to baseline between patients with severe PPMm (14.3 [2.86;28.6] vs. 17.1 [2.85;30.0], p= 0.259) or severe PPMp </sub>(14.3 [2.86;28.6] vs. 18.6 [4.65;26.4], p= 0.871). “In this large healthcare system analysis, at 1-year, neither severe PPMm nor severe PPMp was associated with a lower QOL as compared to no PPM in patients who underwent TAVI,” he concluded. Image Credit: Bailey G. Salimes Image Caption: Karim Al-Azizi, MD, presents during a Late-Breaking Clinical Science session at Cardiovascular Research Technologies (CRT) 2025.