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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Patient-prosthesis mismatch after aortic valve replacement in the elderly
Masaaki Ryomoto1, Masataka Mitsuno, Mitsuhiro Yamamura
1Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, Japan.
General Thoracic and Cardiovascular Surgery
|July 9, 2008
Summary
Patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) in elderly patients did not impact survival or left ventricular mass regression. Mild PPM was common but did not negatively affect outcomes in this retrospective study.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomedical Engineering
Background:
- Patient-prosthesis mismatch (PPM) is a potential concern after aortic valve replacement (AVR), particularly in elderly populations.
- Assessing the impact of PPM on long-term outcomes like survival and cardiac remodeling is crucial for clinical decision-making.
Purpose of the Study:
- To investigate the effect of PPM on survival and left ventricular mass (LVM) regression in elderly patients post-AVR.
- To determine if mild PPM influences midterm outcomes following aortic valve replacement.
Main Methods:
- Retrospective analysis of patients over 65 undergoing isolated AVR between 1990-2007.
- Evaluation of indexed effective orifice area (i-EOA) to define mild PPM (0.65-0.85 cm2/m2).
- Assessment of survival, valve-related death, LVM index, and New York Heart Association (NYHA) functional status.
Main Results:
- Mild PPM was present in 33.6% of elderly patients undergoing AVR.
- No significant difference in freedom from valve-related death at 5 years between PPM-negative and PPM-positive groups.
- Significant LVM index regression observed in both groups, indicating effective cardiac remodeling regardless of PPM status.
Conclusions:
- Mild PPM is prevalent in elderly patients after AVR but does not adversely affect midterm survival.
- Left ventricular mass regression occurs effectively in elderly patients post-AVR, irrespective of mild PPM.
- These findings suggest that mild PPM may not be a significant clinical concern for survival or LVM remodeling in this demographic.
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