Early outcomes of patient-prosthesis mismatch following aortic valve replacement

Perfusion. 2022 Oct;37(7):692-699. doi: 10.1177/02676591211023286. Epub 2021 Jun 3.

Abstract

Introduction: Patient-prosthesis mismatch (PPM) has been associated with numerous short- and long-term adverse events. This study aimed to evaluate the effect of PPM on early postoperative results after aortic valve replacement (AVR) in daily practice.

Methods: In this single-centre retrospective study, 150 non-consecutive patients from March 2019 to January 2020 with clinically indicated AVR with/without concomitant surgery were analysed. The study protocol included operative mortality, complication rate, and pre- and postoperative echocardiographic data. PPM was considered severe with indexed effective orifice area at <0.65 cm2/m2, moderate at 0.65-0.85 cm2/m2 and none at >0.85 cm2/m2.

Results: Moderate PPM was observed in 16 patients (10.6%). No patient had severe PPM. PPM was not related to early mortality (r = 0.40, p = 0.630), intra- (r = -0.076, p = 0.352) and postoperative (r = -0.0134, p = 0.102) events.

Conclusion: In this study, moderate PPM was a frequent finding after AVR, whereas severe PPM was not observed. PPM did not affect the early results after AVR. A long-term follow-up study in a large patient population is required to assess the actual influence of residual PPM.

Keywords: AVR; PPM; aortic valve; heart valve prosthesis; results; valve hemodynamic.

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Follow-Up Studies
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis Implantation* / methods
  • Heart Valve Prosthesis* / adverse effects
  • Humans
  • Prosthesis Design
  • Retrospective Studies
  • Treatment Outcome