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Patient-prosthesis mismatch in patients with aortic valve replacement

Yuichiro Kaminishi1, Yoshio Misawa, Junjiro Kobayashi

  • 1Division of Cardiovascular Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. tcvkamyu@jichi.ac.jp

General Thoracic and Cardiovascular Surgery
|February 14, 2013
PubMed
Abstract

Insights

Patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) was linked to patient factors like age and comorbidities, but not short-term mortality. Understanding these risk factors is key for optimizing AVR outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Clinical Outcomes Research

Background:

  • Patient-prosthesis mismatch (PPM) is a potential concern following aortic valve replacement (AVR).
  • The impact of PPM on clinical outcomes in isolated AVR patients requires further investigation.

Purpose of the Study:

  • To retrospectively examine the prevalence and risk factors of PPM in patients undergoing isolated AVR.
  • To assess the association between PPM and short-term clinical outcomes.

Main Methods:

  • Analysis of isolated AVR cases from the Japan Adult Cardiovascular Surgery Database (JACVSD) between 2008-2009.
  • Definition of PPM as an effective orifice area index ≤ 0.85 m²/cm².
  • Comparison of demographic and clinical characteristics between PPM and non-PPM groups.

Main Results:

  • PPM was identified in 8.5% of 3,609 analyzed cases.
  • PPM patients were older, had higher BMI, and more comorbidities including diabetes, dyslipidemia, hypertension, and coronary artery disease.
  • Increased perioperative blood transfusion, dialysis, postoperative ventilation, and ICU stay were observed in the PPM group.

Conclusions:

  • Key risk factors for PPM include age, aortic valve stenosis, dyslipidemia, hypertension, prior myocardial infarction, percutaneous coronary intervention, diabetes, cerebrovascular disease, and high BMI.
  • PPM was not found to be an independent risk factor for short-term mortality in this cohort.

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