SCHOLTE LUBBERINK, Tessa (2025) Mortality Outcomes in Patients with Small vs. Normal Aortic Annuli undergoing TAVI A retrospective, single-center study. thesis, Medicine.
Full text available on request.Abstract
Background: Transcatheter aortic valve implantation (TAVI) has emerged as a preferred treatment for severe aortic stenosis, particularly in high-risk surgical patients. However, outcomes in patients with small aortic annuli (SAA) remain a topic of debate due to concerns regarding prosthesis-patient mismatch (PPM) and hemodynamic performance. Aims: This study aims to evaluate the impact of aortic annulus size on mortality outcomes following TAVI, comparing patients with small versus normal annuli. Methods: We conducted a single-center retrospective analysis of 594 patients who underwent TAVI at OLVG Heart Center between 2019 and 2023. Patients were classified into two groups based on aortic annulus area: SAA (≤430 mm²) and normal annulus (>430 mm²). Primary outcome measures included all-cause mortality at one year, while secondary outcomes assessed 30-day mortality, annular rupture, and conversion to sternotomy. Procedural factors, valve selection, and survival outcomes were analyzed. Results: Of the 594 patients, 172 (28.96%) had SAA. They were predominantly female (75.6%) with lower body weight and height compared to those with normal annuli. The 1-year mortality rate was comparable between groups (8.1% vs. 8.5%, P=0.816). Similarly, 30-day mortality (1.2% vs. 1.7%, P=0.871) and periprocedural complication rates did not significantly differ. Conclusion: This study demonstrates that TAVI is a safe and effective intervention for patients with SAA, with no significant differences in mortality compared to those with normal annuli. Careful valve selection, particularly the use of supra-annular self-expanding valves, may optimize early outcomes in this subgroup. Further studies are needed to explore long-term hemodynamic performance and durability of transcatheter valves in small annuli.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Amoroso, Dr. G. MD, PhD and Verbeek, E, PhD and Wykrzykowska, Dr. Joanna MD, PhD |
| Faculty: | Medical Sciences |
| Date Deposited: | 05 May 2026 13:29 |
| Last Modified: | 05 May 2026 13:29 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3942 |
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