Yokoyama, HiroakiSugiyama, YoichiMiyashita, HirokazuJalanko, MikkoOchiai, TomokiShishido, KokiYamanaka, FutoshiVähäsilta, TommiSaito, ShigeruLaine, MikaMoriyama, Noriaki2023-03-222023-03-222023-03-15Yokoyama, H, Sugiyama, Y, Miyashita, H, Jalanko, M, Ochiai, T, Shishido, K, Yamanaka, F, Vähäsilta, T, Saito, S, Laine, M & Moriyama, N 2023, 'Impact of Mild Paravalvular Regurgitation on Long- Term Clinical Outcomes After Transcatheter Aortic Valve Implantation', American Journal of Cardiology, vol. 191, pp. 14-22. https://doi.org/10.1016/j.amjcard.2022.12.002http://hdl.handle.net/10138/356438The impact of mild paravalvular regurgitation (PVR) after transcatheter aortic valve implantation (TAVI) remains controversial. We evaluated the impact of mild PVR after TAVI on long-term clinical outcomes. We included patients who underwent TAVI for severe symptomatic aortic stenosis between December 2008 and June 2019 at 2 interna-tional centers and compared all-cause death between the group with mild PVR (group 1) and the group with none or trace PVR (group 2). PVR was categorized using a 3-class grading scheme, and patients with PVR >= moderate and those who were lost to follow-up were excluded. This retrospective analysis included 1,404 patients (mean age 81.7 +/- 6.5 years, 58.0% women). Three hundred fifty eight patients (25.5%) were classified into group 1 and 1,046 patients (74.5%) into group 2. At baseline, group 1 was older and had a lower body mass index, worse co-morbidities, and more severe aortic stenosis. To account for these differences, propensity score matching was performed, resulting in 332 matched pairs. Within these matched groups, during a mean follow-up of 3.2 years, group 1 had a significantly lower survival rate at 5 years (group 1: 62.0% vs group 2: 68.0%, log-rank p = 0.029, hazard ratio: 1.41 [95% confidence interval: 1.04 to 1.91]). In the matched cohort, patients with mild PVR had a significant 1.4-fold increased risk of mortality at 5 years after TAVI compared with those with none or trace PVR. Further studies with more patients are needed to evaluate the impact of longer-term outcomes.(c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) (Am J Cardiol 2023;191:14-22)9engcc_byinfo:eu-repo/semantics/openAccessReplacementPredictorsAssociationInsightsRiskGeneral medicine, internal medicine and other clinical medicineArticleopenAccess43d649aa-04ae-4dc8-8104-d8def537a3783662340985145999252000923477600001