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

Daniel Hernández-Vaquero, Juan C. Llosa, Rocío Díaz, Zain Khalpey, Carlos Morales, Rubén Álvarez, Jose López, Francisco Boye

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

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 years undergoing first-time isolated aortic valve replacement for severe stenosis in our center from September 2007 to September 2011. PPM was defined as an indexed effective orifice area ≤ 0,85 cm2/m2. The influence of PPM on early mortality and postoperative complications was studied using propensity score analysis. Follow up at 30 postoperative days was 100% complete.Results: Of 199 patients studied, 61 (30,7%) had some degree of PPM. PPM was associated with an increased postoperative mortality (OR = 8,71; 95% CI = 1,67-45,29; p = 0,04) and major postoperative complications (OR = 2,96; CI = 1,03-8,55; p = 0,044). However, no association between PPM and prolonged hospital or ICU stay was demonstrated.Conclusions: Moderate PPM is a common finding in young and middle-aged patients undergoing surgery for aortic valve replacement due to severe stenosis. In addition, its influence on early outcomes may be relevant.

Original languageEnglish (US)
Article number46
JournalJournal of Cardiothoracic Surgery
Volume7
Issue number1
DOIs
StatePublished - May 15 2012

Keywords

  • Patient-prosthesis mismatch
  • Severe aortic stenosis

ASJC Scopus subject areas

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

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