title: Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Implantation.
abstract: BACKGROUND
  We reviewed currently available studies that investigated prosthesis-patient mismatch (PPM) in transcatheter aortic valve implantation (TAVI) with a systematic literature search and meta-analytic estimates.
  
  
  METHODS
  To identify all studies that investigated PPM in TAVI, MEDLINE and EMBASE were searched through August 2015. Studies considered for inclusion met the following criteria: the study population included patients undergoing TAVI and outcomes included at least post-procedural PPM prevalence. We performed three quantitative meta-analyses about (1) PPM prevalence after TAVI, (2) PPM prevalence after TAVI versus surgical aortic valve replacement (SAVR), and (3) late all-cause mortality after TAVI in patients with PPM versus patients without PPM.
  
  
  RESULTS
  We identified 21 eligible studies that included data on a total of 4,000 patients undergoing TAVI. The first meta-analyses found moderate PPM prevalence of 26.7%, severe PPM prevalence of 8.0%, and overall PPM prevalence of 35.1%. The second meta-analyses of six studies, including 745 patients, found statistically significant reductions in moderate (p = 0.03), severe (p = 0.0003), and overall (p = 0.02) PPM prevalence after TAVI relative to SAVR. The third meta-analyses of five studies, including 2,654 patients, found no statistically significant differences in late mortality between patients with severe PPM and patients without PPM (p = 0.44) and between patients with overall PPM and patients without PPM (p = 0.97).
  
  
  CONCLUSIONS
  Overall, moderate, and severe PPM prevalence after TAVI was 35%, 27%, and 8%, respectively, which may be less than that after SAVR. In contrast to PPM after SAVR, PPM after TAVI may not impair late survival.
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan. Electronic address: kfgth973@ybb.ne.jp.
authors.forename: Hisato
authors.initials: H
authors.lastname: Takagi
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Umemoto
mesh_terms: D001024:Aortic Valve Stenosis / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D011183:Postoperative Complications; D011475:Prosthesis Failure; D012307:Risk Factors; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*