Measuring TAVR Prosthesis Gradient Immediately Post-Procedure May Underestimate its Significance

A high mean aortic valve gradient after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement has been associated with reduced survival and recurrent hospitalization for heart failure (1). Measurement of the mean transcatheter heart valve (Tl1V) prosthesis gradient immediately post· procedure may underestimate the significance of the gradient due to a low-flow state (2).

We measured the mean prosthetic valve echocardiographic gradient in 200 patients immediately after receiving a self-expanding Evolut Pro + (n = 100, Medtronic)  or  balloon-.expandable  SAPIEN  3 Ultra (n= 100, Edwards  Lifesciences)  THV for  severe, symptomatic native aortic stenosis.