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Patient-Prosthesis Mismatch in Aortic Valve Replacement With No.19 Prosthesis: Impact on Early and Late Outcomes
Selman Dumani1, Alessia Mehmeti2, Ermal Likaj1
1Division of Cardiac Surgery, University Hospital Center "Mother Theresa", Tirana, ALB.
Cureus
|April 7, 2025
Summary
Patient-prosthesis mismatch (PPM) after aortic valve replacement does not impact early or late mortality. However, severe mismatch is linked to reduced long-term symptomatic improvement in patients.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
Background:
- Patient-prosthesis mismatch (PPM) is a significant concern in aortic valve surgery outcomes.
- Prosthesis No. 19 was used in this study evaluating PPM incidence and impact.
Purpose of the Study:
- To assess the incidence of PPM in patients undergoing aortic valve replacement with prosthesis No. 19.
- To evaluate the influence of PPM on early and late outcomes, including mortality and functional status.
Main Methods:
- A cohort of 175 patients received aortic valve replacement with prosthesis No. 19, followed for up to 10 years.
- PPM was defined by indexed effective orifice area (EOAi).
- Outcomes included hospital mortality, long-term mortality, and New York Heart Association (NYHA) functional class changes.
Main Results:
- The incidence of overall and severe PPM was 69.1% and 29.7%, respectively.
- Severe PPM and indexed effective orifice area did not significantly affect early hospital mortality.
- Severe PPM and indexed effective orifice area were associated with less improvement in NYHA functional class long-term (p<0.015).
Conclusions:
- Severe PPM and small indexed orifice areas do not influence early or late mortality after aortic valve replacement.
- Importantly, severe mismatch is related to diminished symptomatic improvement in the long term.
