ArticleStructural heart : the journal of the Heart Team2026
Different Types of Aortic Valve Stenosis in Patients Undergoing Transcatheter Aortic Valve Replacement.
Article in Structural heart : the journal of the Heart Team, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Beyond Gradient, Beyond Flow: Rethinking Risk Stratification in Aortic Stenosis.Structural heart : the journal of the Heart Team · 2026Article
- Gradient Is Not Enough: Stroke Volume Index as the True Arbiter of Risk in Advanced Aortic Stenosis.Structural heart : the journal of the Heart Team · 2026Article
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25 authors.
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Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an effective treatment in patients with "classical" concordant high-gradient aortic stenosis (AS). However, data on outcomes in patients with discordant AS are scarce. Our study aims to investigate the clinical outcomes of patients undergoing TAVR with different types of AS. Methods: The Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Implantation 2 (CENTER2) study is a patient-level database including 25,771 patients who underwent TAVR, of whom 15,233 were included in this analysis. Four AS subgroups were identified, and patients were classified as discordant AS (low-gradient AS with preserved or impaired left ventricular ejection fraction [LVEF] or discordant high-gradient AS) or concordant high-gradient AS. Results: A total of 15,233 patients underwent TAVR. The mean age was 81.5 ± 6.8 years, 56% were women, and Society of Thoracic Surgeons Predicted Risk of Mortality was 4.8% (interquartile range [IQR] 3.0-8.0%). Of these, 2731 (17.9%) patients had low-gradient AS with preserved or impaired LVEF, 138 (0.9%) discordant high-gradient AS, and 12,364 (81.2%) concordant high-gradient AS. There was no difference in 1-year mortality between discordant AS and concordant high-gradient AS (13.1 vs. 11.9%, adjusted hazard ratio 1.19, Conclusions: Nearly 20% of patients undergoing TAVR had discordant AS. One-year mortality was higher in low-gradient AS with impaired LVEF, whereas outcomes were similar among low-gradient with preserved LVEF, discordant high-gradient, and concordant high-gradient AS.
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