Related Experiment Video
Updated: Feb 4, 2026
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Prosthesis-patient mismatch after mitral valve replacement: a single-centered retrospective analysis in East China
Armah M Akuffu1, Haige Zhao1, Junnan Zheng2
1Department of Cardiothoracic Surgery, the First Affiliated Hospital of Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, China.
Background:
Prosthesis-patient mismatch (PPM) may affect the clinical outcomes of patients undergoing mitral valve replacement (MVR) surgery. We aimed to investigate the incidence of PPM of the mitral position in our center and analyze the possible predictors of PPM as well as its effect on short-term outcomes.
Methods:
We retrospectively examined all consecutive patients with isolated or concomitant MVR at our center from 2013 to 2015. PPM was defined as an indexed effective orifice area (iEOA) of ≤1.2 cm2/m2. After inclusion and exclusion, a total of 1067 patients were analyzed. The baseline information were collected and compared between the two groups. Multivariate logistic regression analysis was conducted to determine the preoperative predictors of PPM as well as the effect of PPM on early mortality.
Results:
A total of 1067 patients were included in the study. PPM was detected in 15.9% of the patients while 12 patients (1.12%) met the criteria for severe PPM. Patients with PPM compared to the non-PPM patients had higher age, larger body surface area and were more likely to be male and obese. Logistic regression analysis showed that higher age, larger BSA, bioprosthesis and smaller left ventricle end-diastolic diameter were predictors of PPM. There were no significant differences between the PPM and non-PPM groups regarding post-operative complications. Logistic regression analysis showed that PPM was not a risk factor of short-term mortality (P = 0.654). Also, there were no significant differences regarding short-/mid-term heart function between the PPM and non PPM groups (P = 0.902).
Conclusions:
Our results demonstrated that higher age, bioprosthesis, larger BSA and smaller left ventricle size were associated with mitral PPM. However, PPM was not associated with poorer early outcomes after MVR surgery. In eastern of China, the prevalence of mitral valve stenosis is high; therefore, whether the standard PPM criteria are suitable for patients of this district needs to be further verified.
Insights
Prosthesis-patient mismatch (PPM) after mitral valve replacement occurred in 15.9% of patients. Higher age, larger body surface area, and bioprosthesis use predicted PPM, but it did not impact short-term outcomes.
Area of Science:
- Cardiovascular Surgery
- Prosthetic Heart Valves
- Clinical Outcomes
Background:
- Prosthesis-patient mismatch (PPM) is a potential concern following mitral valve replacement (MVR).
- Understanding PPM incidence and predictors is crucial for optimizing surgical outcomes.
- This study investigates PPM in the mitral position at a specific center.
Purpose of the Study:
- To determine the incidence of PPM in mitral valve replacement (MVR) surgery.
- To identify predictors of PPM in the mitral position.
- To analyze the effect of PPM on short-term clinical outcomes after MVR.
Main Methods:
- Retrospective analysis of 1067 patients undergoing MVR between 2013 and 2015.
- PPM defined by indexed effective orifice area (iEOA) ≤1.2 cm²/m².
- Multivariate logistic regression used to identify predictors and assess outcomes.
Main Results:
- PPM detected in 15.9% of patients; severe PPM in 1.12%.
- Predictors of PPM included higher age, larger body surface area (BSA), bioprosthesis use, and smaller left ventricle end-diastolic diameter.
- No significant differences in post-operative complications, short-term mortality, or heart function between PPM and non-PPM groups.
Conclusions:
- Higher age, bioprosthesis, larger BSA, and smaller left ventricle size are associated with mitral PPM.
- Mitral PPM was not linked to adverse early outcomes following MVR surgery.
- Further validation of standard PPM criteria is needed for populations with high mitral valve stenosis prevalence.
More Related Videos
Related Concept Videos
01:27Mitral Valve Prolapse I: Introduction
01:36Mismatch Repair
01:20Mismatch Repair
The Mutator Protein Family Plays a Key Role in DNA Mismatch Repair
The human genome has more than 3 billion base pairs of DNA per cell. Prior to cell division, that vast amount of genetic...
01:22Mitral Valve Prolapse II: Assessment and Management
01:13Patient-centered Care
01:19Mitral Valve Prolapse III: Nursing Management