BACKGROUND: This study assessed the effects of prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR) using mechanical prostheses in patients with aortic stenosis. METHODS: A total of 124 patients with aortic stenosis who underwent AVR with mechanical prostheses were followed (mean 9.1+/-4.9 years). The patients were divided into two groups based on the effective orifice area index (EOAI): Group A did not have significant PPM, defined as an EOAI>or=0.85 cm2/m2; and the PPM group had significant PPM, defined as an EOAI<0.85 cm2/m2. RESULTS: In all, 25 patients (20.2%) had PPM. The operative mortality was 6.1% in group A and 12.0% in the PPM group; the difference between the groups was not significant. Moreover, the difference in overall survival rates between group A and the PPM group was not statistically significant (15-year postoperative survival: group A 78.5% vs. PPM group 81.3%). Although there were four late deaths in the PPM group, only one was valve-related. PPM had no effect on late survival. Postoperatively, cardiac function and physical activity levels improved in both groups; the extent of improvement was not dependent on the presence or severity of PPM. CONCLUSION: Although PPM may affect operative mortality, the effect of PPM appears to decrease over time. PPM had no effect on late survival.
BACKGROUND: This study assessed the effects of prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR) using mechanical prostheses in patients with aortic stenosis. METHODS: A total of 124 patients with aortic stenosis who underwent AVR with mechanical prostheses were followed (mean 9.1+/-4.9 years). The patients were divided into two groups based on the effective orifice area index (EOAI): Group A did not have significant PPM, defined as an EOAI>or=0.85 cm2/m2; and the PPM group had significant PPM, defined as an EOAI<0.85 cm2/m2. RESULTS: In all, 25 patients (20.2%) had PPM. The operative mortality was 6.1% in group A and 12.0% in the PPM group; the difference between the groups was not significant. Moreover, the difference in overall survival rates between group A and the PPM group was not statistically significant (15-year postoperative survival: group A 78.5% vs. PPM group 81.3%). Although there were four late deaths in the PPM group, only one was valve-related. PPM had no effect on late survival. Postoperatively, cardiac function and physical activity levels improved in both groups; the extent of improvement was not dependent on the presence or severity of PPM. CONCLUSION: Although PPM may affect operative mortality, the effect of PPM appears to decrease over time. PPM had no effect on late survival.
Authors: Marc Ruel; Hussam Al-Faleh; Alexander Kulik; Kwan L Chan; Thierry G Mesana; Ian G Burwash Journal: J Thorac Cardiovasc Surg Date: 2006-05 Impact factor: 5.209
Authors: N Vitale; I Caldarera; C Muneretto; R Sinatra; A Scafuri; E Di Rosa; A Contini; N Tedesco; A Pierangeli; M Abbate; T Gherli; D Casarotto; M Di Summa; B Marino; L Chiariello; L de Luca Journal: J Thorac Cardiovasc Surg Date: 2001-10 Impact factor: 5.209
Authors: Rafael García Fuster; José A Montero Argudo; Oscar Gil Albarova; Fernando Hornero Sos; Sergio Cánovas López; María Bueno Codoñer; José A Buendía Miñano; Ignacio Rodríguez Albarran Journal: Eur J Cardiothorac Surg Date: 2004-12-25 Impact factor: 4.191