Clinical outcomes following transcatheter aortic valve replacement in patients with concordant versus discordant aortic stenosis

American Heart Journal Plus · Published 2026-05-19 · DOI 10.1016/j.ahjo.2026.100802

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Authors (10)

Prabhjot Hundal, Zaid Abood, Viviana Zlochiver, David Boulware, Mohamed Osman, Renuka Jain, Suhail Allaqaband, Tanvir Bajwa, A. Jamil Tajik, M. Fuad Jan

Abstract

Study objective: This study aimed to evaluate clinical outcomes of patients with symptomatic discordant (aortic stenosis) AS following transcatheter aortic valve replacement (TAVR). Design: This is a retrospective cohort study. Setting: Patients who underwent a TAVR for severe symptomatic native AS with preserved left ventricular ejection fraction ≥50% from 2012 to 2022 at our institution were included. Participants: Patients were divided into two cohorts, concordant AS (met all AS criteria) and discordant AS (< 3 criteria). Interventions: TAVR. Main outcomes measures: The primary endpoint was all cause mortality and secondary outcomes were hospital readmissions for myocardial infarction (MI) and stroke. Results: This study evaluated 2021 patients; the median age was 82.6 (77.0–87.2) years, and 53% were female. There was no difference in long-term mortality between discordant or concordant AS (HR: 0.89 [95% CI: 0.77–1.02]; P = 0.09). However, the discordant group had a higher 1-year mortality rate than the concordant group (14.5% vs 10.1%, respectively; P = 0.0054) and comparable mortality rates at 5 years (52.0% vs 50.5%, respectively; P = 0.18). The long-term readmission rate for MI was higher for the discordant group (HR: 0.47 [95% CI: 0.27–0.80]; P = 0.005), and there was no difference in readmission for stroke or transient ischemic attack (HR: 1.33 [95% CI: 0.92–1.94]; P = 0.133). Conclusions: Patients with symptomatic severe AS with discordant echocardiographic findings may have similar survival outcomes than those with concordant AS after undergoing TAVR.

Abstract from DOAJ. Public domain (CC0 1.0).

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Publication details

Year
2026

Citation

Hundal, P., Abood, Z., Zlochiver, V., et al. (2026). Clinical outcomes following transcatheter aortic valve replacement in patients with concordant versus discordant aortic stenosis. American Heart Journal Plus. https://doi.org/10.1016/j.ahjo.2026.100802

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