BACKGROUND: Previous studies have shown that prosthesis-patient mismatch (PPM) results in higher early and late mortality after bioprosthetic aortic valve replacement. Careful selection of stented bioprostheses was recommended to avoid inadequate effective orifice area. We studied the incidence of PPM and its potential effects on clinical outcome in patients undergoing aortic valve replacement using the Carpentier-Edwards Perimount bioprosthesis. METHODS: Independent predictors of early and late mortality and hospital readmission for cardiac reasons were defined in 506 patients (mean age, 73 years; range, 57 to 87 years) by multivariate analysis. Mean follow-up was 6.1 +/- 4.8 years; maximum follow-up was 18.6 years. RESULTS: The incidence of severe PPM (effective orifice area index < 0.65 cm2/m2) was 0.2% and of moderate PPM (effective orifice area index > 0.65 and < 0.85) was 20%. Multivariate analysis revealed that moderate PPM was not an independent predictor of early mortality, late mortality, or hospital readmission for cardiac reasons. Reduction of septal hypertrophy was similar in patients with and without moderate PPM. CONCLUSIONS: The incidence of severe PPM is virtually nonexistent after aortic valve replacement using the Carpentier-Edwards Perimount valve. Moderate PPM is found in 20% of cases and is clinically irrelevant in this population.
BACKGROUND: Previous studies have shown that prosthesis-patient mismatch (PPM) results in higher early and late mortality after bioprosthetic aortic valve replacement. Careful selection of stented bioprostheses was recommended to avoid inadequate effective orifice area. We studied the incidence of PPM and its potential effects on clinical outcome in patients undergoing aortic valve replacement using the Carpentier-Edwards Perimount bioprosthesis. METHODS: Independent predictors of early and late mortality and hospital readmission for cardiac reasons were defined in 506 patients (mean age, 73 years; range, 57 to 87 years) by multivariate analysis. Mean follow-up was 6.1 +/- 4.8 years; maximum follow-up was 18.6 years. RESULTS: The incidence of severe PPM (effective orifice area index < 0.65 cm2/m2) was 0.2% and of moderate PPM (effective orifice area index > 0.65 and < 0.85) was 20%. Multivariate analysis revealed that moderate PPM was not an independent predictor of early mortality, late mortality, or hospital readmission for cardiac reasons. Reduction of septal hypertrophy was similar in patients with and without moderate PPM. CONCLUSIONS: The incidence of severe PPM is virtually nonexistent after aortic valve replacement using the Carpentier-Edwards Perimount valve. Moderate PPM is found in 20% of cases and is clinically irrelevant in this population.
Authors: Damien J LaPar; Gorav Ailawadi; Castigliano M Bhamidipati; George Stukenborg; Ivan K Crosby; John A Kern; Irving L Kron Journal: Ann Thorac Surg Date: 2011-09 Impact factor: 4.330
Authors: Sabine Bleiziffer; Walter B Eichinger; Ina Hettich; Ralf Guenzinger; Daniel Ruzicka; Robert Bauernschmitt; Ruediger Lange Journal: Heart Date: 2006-12-12 Impact factor: 5.994
Authors: Bart M Koene; Mohamed A Soliman Hamad; Wobbe Bouma; Massimo A Mariani; Kathinka C Peels; Jan-Melle van Dantzig; Albert H van Straten Journal: J Cardiothorac Surg Date: 2013-04-17 Impact factor: 1.637
Authors: Bart M Koene; Mohamed A Soliman Hamad; Wobbe Bouma; Massimo A Mariani; Kathinka C Peels; Jan-Melle van Dantzig; Albert H van Straten Journal: Clin Res Cardiol Date: 2013-10-18 Impact factor: 5.460
Authors: José M Arribas-Leal; José Miguel Rivera-Caravaca; Ramón Aranda-Domene; José A Moreno-Moreno; Dolores Espinosa-Garcia; Antonio Jimenez-Aceituna; Joaquín Perez-Andreu; Rubén Taboada-Martin; Daniel R Saura-Espin; Sergio J Canovas-Lopez Journal: Interact Cardiovasc Thorac Surg Date: 2021-10-29