Patient-prosthesis mismatch in patients with aortic valve replacement

Yuichiro Kaminishi, Yoshio Misawa, Junjiro Kobayashi, Hiroaki Konishi, Hiroaki Miyata, Noboru Motomura, Shin Ichi Takamoto

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Objective: Patient-prosthesis mismatch (PPM) may affect clinical outcomes in patients with aortic valve replacement (AVR). We retrospectively examined the PPM in patients with isolated AVR in the Japan Adult Cardiovascular Surgery Database (JACVSD). Methods: We examined all patients with isolated AVR between January 1, 2008 and December 31, 2009. The JACVSD data collection form has a total of 255 variables. We defined PPM as an effective orifice area index of ≤0.85 m2/cm2. Results: PPM was observed in 306 of 3,609 cases analyzed, PPM rate was 8.5 %. Body surface area was larger and body mass index was higher in the PPM group than the non-PPM group (P < 0.001). Patients with PPM were older (P = 0.001) and had a higher prevalence of diabetes (P = 0.004), dyslipidemia (P < 0.001), hypertension (P < 0.001), cerebrovascular disease (P = 0.031), old myocardial infarction (P = 0.006), previous percutaneous coronary artery intervention (P = 0.001), coronary artery disease (P = 0.018), and aortic valve stenosis (P < 0.001). Perioperative blood transfusion (P < 0.001) and dialysis (P = 0.005) were more frequent in the PPM group. Postoperative ventilation (P = 0.004) and intensive care unit stay (P = 0.004) were significantly longer in the PPM group. Conclusions: Age, aortic valve stenosis, dyslipidemia, hypertension, old myocardial infarction, previous percutaneous coronary artery intervention, diabetes mellitus, cerebrovascular disease, and high body mass index were the risk factors for PPM. PPM was not an independent risk factor for short-term mortality.

Original languageEnglish
Pages (from-to)274-279
Number of pages6
JournalGeneral thoracic and cardiovascular surgery
Volume61
Issue number5
DOIs
Publication statusPublished - 2013 May
Externally publishedYes

Keywords

  • Aortic valve replacement
  • Hemodynamics
  • Mortality
  • Prosthesis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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