OBJECTIVES: This study sought to evaluate the impact of patient-prosthesis mismatch (PPM) on the risk of perioperative, early-, mid- and long-term mortality rates after surgical aortic valve replacement. METHODS: Databases were searched for studies published until March 2018. The main outcomes of interest were perioperative mortality, 1-year mortality, 5-year mortality and 10-year mortality. RESULTS: The search yielded 3761 studies for inclusion. Of these, 70 articles were analysed, and their data were extracted. The total number of patients included was 108 182 who underwent surgical aortic valve replacement. The incidence of PPM after surgical aortic valve replacement was 53.7% (58 116 with PPM and 50 066 without PPM). Perioperative mortality [odds ratio (OR) 1.491, 95% confidence interval (CI) 1.302-1.707; P < 0.001], 1-year mortality (OR 1.465, 95% CI 1.277-1.681; P < 0.001), 5-year mortality (OR 1.358, 95% CI 1.218-1.515; P < 0.001) and 10-year mortality (OR 1.534, 95% CI 1.290-1.825; P < 0.001) were increased in patients with PPM. Both severe PPM and moderate PPM were associated with increased risk of perioperative mortality, 1-year mortality, 5-year mortality and 10-year mortality when analysed together and separately, although we observed a higher risk in the group with severe PPM. CONCLUSIONS: Moderate/severe PPM increases perioperative, early-, mid- and long-term mortality rates proportionally to its severity. The findings of this study support the implementation of surgical strategies to prevent PPM in order to decrease mortality rates.
OBJECTIVES: This study sought to evaluate the impact of patient-prosthesis mismatch (PPM) on the risk of perioperative, early-, mid- and long-term mortality rates after surgical aortic valve replacement. METHODS: Databases were searched for studies published until March 2018. The main outcomes of interest were perioperative mortality, 1-year mortality, 5-year mortality and 10-year mortality. RESULTS: The search yielded 3761 studies for inclusion. Of these, 70 articles were analysed, and their data were extracted. The total number of patients included was 108 182 who underwent surgical aortic valve replacement. The incidence of PPM after surgical aortic valve replacement was 53.7% (58 116 with PPM and 50 066 without PPM). Perioperative mortality [odds ratio (OR) 1.491, 95% confidence interval (CI) 1.302-1.707; P < 0.001], 1-year mortality (OR 1.465, 95% CI 1.277-1.681; P < 0.001), 5-year mortality (OR 1.358, 95% CI 1.218-1.515; P < 0.001) and 10-year mortality (OR 1.534, 95% CI 1.290-1.825; P < 0.001) were increased in patients with PPM. Both severe PPM and moderate PPM were associated with increased risk of perioperative mortality, 1-year mortality, 5-year mortality and 10-year mortality when analysed together and separately, although we observed a higher risk in the group with severe PPM. CONCLUSIONS: Moderate/severe PPM increases perioperative, early-, mid- and long-term mortality rates proportionally to its severity. The findings of this study support the implementation of surgical strategies to prevent PPM in order to decrease mortality rates.
Authors: Luca Testa; Matteo Casenghi; Enrico Criscione; Nicolas M Van Mieghem; Didier Tchétché; Anita W Asgar; Ole De Backer; Azeem Latib; Bernhard Reimers; Giulio Stefanini; Carlo Trani; Francesco Giannini; Antonio Bartorelli; Wojtek Wojakowski; Maciej Dabrowski; Dariusz Jagielak; Adrian P Banning; Rajesh Kharbanda; Raul Moreno; Joachim Schofer; Christina Brinkmann; Niels van Royen; Duane Pinto; Antoni Serra; Amit Segev; Arturo Giordano; Nedy Brambilla; Mauro Agnifili; Antonio Popolo Rubbio; Mattia Squillace; Jacopo Oreglia; Rudolph Tanja; James M McCabe; Alexander Abizaid; Michiel Voskuil; Rui Teles; Giuseppe Biondi Zoccai; Lars Sondergaard; Francesco Bedogni Journal: Front Cardiovasc Med Date: 2022-07-29
Authors: Michiel D Vriesendorp; Rob A F De Lind Van Wijngaarden; Stuart J Head; Arie-Pieter Kappetein; Graeme L Hickey; Vivek Rao; Neil J Weissman; Michael J Reardon; Michael G Moront; Joseph F Sabik; Robert J M Klautz Journal: Eur Heart J Cardiovasc Imaging Date: 2020-10-01 Impact factor: 6.875