Prosthesis-Patient Mismatch After Aortic Valve Replacement: Effect on Long-Term Survival

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Clinical Outcomes Research

Background:

• Previous studies on prosthesis-patient mismatch after aortic valve replacement (AVR) had limited follow-up (≤10 years).
• This study aimed to assess the long-term survival impact of prosthesis-patient mismatch following AVR with extended follow-up.

Purpose of the Study:

• To investigate the effect of prosthesis-patient mismatch on long-term survival after AVR.
• To determine if prosthesis-patient mismatch is an independent predictor of decreased long-term survival in AVR patients.

Main Methods:

• Retrospective longitudinal cohort study of 673 consecutive AVR patients.
• Kaplan-Meier survival analysis and Cox multiple regression were used.
• Patients were categorized based on indexed effective orifice area (≤0.85 cm(2)/m(2) for mismatch).

Main Results:

• Mean follow-up was 17.8 years.
• Prosthesis-patient mismatch was not an independent predictor of decreased long-term survival (HR 0.828, p=0.083).
• Severe mismatch (≤0.65 cm(2)/m(2)) showed a non-significant trend toward decreased survival (HR 1.68, p=0.066).

Conclusions:

• Prosthesis-patient mismatch is not an independent predictor of decreased long-term survival after AVR.
• Extended follow-up confirms the lack of significant impact from mismatch on long-term AVR outcomes.