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Prosthesis-patient mismatch is associated with higher operative mortality following aortic valve replacement

Cheng-Hon Yap1, Morteza Mohajeri, Michael Yii

  • 1Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria 3065, Australia. Cheng-Hon.YAP@svhm.org.au

Heart, Lung & Circulation
|April 20, 2007
PubMed
Abstract

Insights

Severe prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR) significantly increases operative mortality. Avoiding PPM is crucial for reducing patient deaths following AVR surgery.

Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Patient Outcomes

Background:

  • Prosthesis-patient mismatch (PPM) occurs when an implanted heart valve is too small for the patient's body size, leading to high pressure gradients.
  • This study investigates the association between severe PPM and early complications after aortic valve replacement (AVR).

Purpose of the Study:

  • To determine if severe prosthesis-patient mismatch (PPM) is linked to increased early morbidity and mortality following aortic valve replacement (AVR).

Main Methods:

  • Prospective data from 701 patients undergoing AVR between 2001 and 2006 were analyzed.
  • Indexed valve effective orifice area (IEOA) was calculated to define PPM (
  • PPM's correlation with operative mortality, stroke, prolonged ventilation, renal failure, and extended hospital/ICU stays was assessed using univariate and multivariate analyses.

Main Results:

  • Severe PPM was identified in 6.6% of patients, with an overall operative mortality of 4.1%.
  • Patients with PPM had a significantly higher risk of operative mortality (multivariate OR 6.1, P=0.006).
  • PPM was not associated with other adverse outcomes like stroke, prolonged ventilation, renal failure, or extended hospital stays.

Conclusions:

  • Prosthesis-patient mismatch (PPM) is significantly associated with increased operative mortality after AVR.
  • Avoiding PPM during AVR surgery is recommended to potentially reduce patient mortality.

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