[Moderate patient-prosthesis mismatch has no independent effect on 30-day mortality after isolated aortic valve replacement].

نویسندگان

  • Stefano Urso
  • Rafael Sadaba
  • Toni Monleón-Getino
  • Gonzalo Aldamiz-Echevarría
چکیده

INTRODUCTION AND OBJECTIVES It is still not clear whether the presence of a moderate patient-prosthesis mismatch after isolated aortic valve replacement can increase 30-day mortality. The aim of this study was to determine whether a moderate mismatch is an independent predictor of early global or cardiac mortality after aortic valve replacement. METHODS The study involved 272 adult patients (median age, 72 years; interquartile range, 66-76 years) undergoing isolated aortic valve replacement. Moderate mismatch was considered to be present if the projected indexed effective orifice area was < or =0.85 and >0.65 cm2/m2. Severe mismatch was present if the projected indexed effective orifice area was < or =0.65 cm2/m2. Follow-up to assess survival at 30 days was carried out in 100% of patients. RESULTS Moderate mismatch was observed in 37.9% of patients. None had a severe mismatch. Multivariate analysis identified the following independent predictors of global mortality at 30 days: left ventricular ejection fraction <50% (P=.03) and age (P=.01). The same variables were identified as predictors of 30-day cardiac survival, but at a higher level of statistical significance: left ventricular ejection fraction <50% (P=.006) and age (P=.008). The analysis did not identify moderate mismatch as a predictor of global or cardiac 30-day mortality in our study population. CONCLUSIONS Our findings indicate that the evidence that inserting a prosthesis of the measured size in a small aortic annulus compromises the patient's survival is far from clear when the patient-prosthesis mismatch is moderate.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Seventeen-millimeter St. Jude Medical Regent valve in patients with small aortic annulus: dose moderate prosthesis-patient mismatch matter?

BACKGROUND The study was designed to evaluate the effects of moderate prosthesis-patient mismatch (defined as 0.65 cm(2)/m(2) <indexed effective orifice area ≤ 0.85 cm(2)/m(2)) on midterm outcomes after isolated aortic valve replacement with a 17-mm St. Jude Medical Regent valve in a large series of patients, and to determine if these effects are influenced by patient confounding variables. M...

متن کامل

[Influence of patient-prosthesis mismatch in the octogenarian undergoing surgery for aortic valve replacement due to severe stenosis].

INTRODUCTION AND OBJECTIVES The clinical impact of patient-prosthesis mismatch on the outcome in octogenarians who undergo surgery for aortic valve replacement due to severe stenosis is unknown. Our objective was to quantify the frequency of some degree of patient-prosthesis mismatch and its impact on mortality and life quality. METHODS We analyzed all the octogenarian patients who underwent ...

متن کامل

Impact of patient-prosthesis mismatch on 30-day outcomes in young and middle-aged patients undergoing aortic valve replacement

BACKGROUND The impact of patient-prosthesis mismatch (PPM) on early outcomes in young and middle-aged patients undergoing conventional aortic valve replacement for severe aortic stenosis remains unknown. Our objective was to evaluate the incidence of some degree of PPM and its influence on early mortality and morbidity. METHODS We analyzed our single center experience in all patients <70 year...

متن کامل

Moderate Patient-Prosthesis Mismatch Has No Negative Effect on Patients’ Functional Status After Aortic Valve Replacement With CarboMedics Prosthesis

BACKGROUND Patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) is the subject of continuing debate in the cardiac surgery field. OBJECTIVES The aim of this study was to evaluate the frequency and severity of patient-prosthesis mismatch (PPM) and the functional status of patients undergoing aortic valve replacement (AVR) using a CarboMedics prosthesis in the mid-term follow ...

متن کامل

Impact of valve prosthesis-patient mismatch on short-term mortality after aortic valve replacement.

BACKGROUND The prosthesis used for aortic valve replacement (AVR) can be too small in relation to body size, thus causing valve prosthesis-patient mismatch (PPM) and abnormally high transvalvular pressure gradients. This study examined if there is a relation between PPM and short-term mortality after operation. METHODS AND RESULTS The indexed valve effective orifice area (EOA) was estimated f...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Revista espanola de cardiologia

دوره 63 4  شماره 

صفحات  -

تاریخ انتشار 2010