BACKGROUND AND AIM OF THE STUDY: The study aim was to analyze the relationship between patient-prosthesis mismatch (PPM) and in-hospital complications and mortality after aortic valve replacement (AVR). METHODS: AVR was performed in 1,819 patients between January 1996 and July 2006. Follow up investigations were performed after a mean of 4.3 years (range: 0 days to 10.6 years). Univariate and multivariate analysis were used to evaluate risk factors for in-hospital complications and mortality in patients with prosthesis mismatch. Actuarial statistics were used to calculate survival rates. RESULTS: Multivariate analysis showed that PPM (defined as indexed effective orifice area < or = 0.85 cm2/m2) was associated with an increased risk of postoperative neurological events (OR 2.26, 95% CI 1.05-4.83, p = 0.037). There were no significant differences in 30-day mortality between the PPM and non-PPM groups. Neither was any significant difference found between the two groups regarding long-term survival adjusted for significant risk factors for death after AVR. CONCLUSION: The results suggest PPM to be an independent predictor of postoperative neurological complications in patients undergoing AVR. However, PPM did not negatively influence either short- or long-term survival. PPM may play an important role in selected categories of patients, and should be considered in order to avoid postoperative neurological complications.
BACKGROUND AND AIM OF THE STUDY: The study aim was to analyze the relationship between patient-prosthesis mismatch (PPM) and in-hospital complications and mortality after aortic valve replacement (AVR). METHODS: AVR was performed in 1,819 patients between January 1996 and July 2006. Follow up investigations were performed after a mean of 4.3 years (range: 0 days to 10.6 years). Univariate and multivariate analysis were used to evaluate risk factors for in-hospital complications and mortality in patients with prosthesis mismatch. Actuarial statistics were used to calculate survival rates. RESULTS: Multivariate analysis showed that PPM (defined as indexed effective orifice area < or = 0.85 cm2/m2) was associated with an increased risk of postoperative neurological events (OR 2.26, 95% CI 1.05-4.83, p = 0.037). There were no significant differences in 30-day mortality between the PPM and non-PPM groups. Neither was any significant difference found between the two groups regarding long-term survival adjusted for significant risk factors for death after AVR. CONCLUSION: The results suggest PPM to be an independent predictor of postoperative neurological complications in patients undergoing AVR. However, PPM did not negatively influence either short- or long-term survival. PPM may play an important role in selected categories of patients, and should be considered in order to avoid postoperative neurological complications.
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: Daniel Hernández-Vaquero; Juan C Llosa; Rocío Díaz; Zain Khalpey; Carlos Morales; Rubén Álvarez; Jose López; Francisco Boye Journal: J Cardiothorac Surg Date: 2012-05-15 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