Does prosthesis–patient mismatch affect outcome of aortic valve replacement?


Does prosthesis–patient mismatch affect outcome of aortic valve replacement?

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Tasca G _ et al_. (2006) Impact of prosthesis–patient mismatch on cardiac events and midterm mortality after aortic valve replacement in patients with pure aortic stenosis. _Circulation_


113: 570–576 Prosthesis–patient mismatch (PPM) occurs when a prosthetic aortic valve with a smaller effective orifice area (EOA) than that of the patient's native valve is implanted.


PPM results in abnormally high transvalvular pressure gradients, but it is unclear whether postoperative survival is affected. Tasca _ et al_. investigated the effect of PPM, defined as an


INDEXED EOA, on overall out-of-hospital mortality and cardiac events after aortic valve replacement (AVR). The study included 315 patients who underwent AVR for pure aortic stenosis at a


hospital in Brescia, Italy, from September 1997 to September 2003. Follow-up visits at 3 months and annual telephone interviews were used to investigate mortality and cardiac events (cardiac


death, sudden death, hospital readmission for angina, heart failure or syncope). Mean follow-up was 3.7 ± 1.7 years. PPM occurred in 47% of patients. Patients with PPM were older, had


higher body surface area, had a higher BMI and were more likely to be female than patients without PPM (_P_ <0.001, _P_ = 0.007, _P_ <0.001 and _P_ = 0.003, respectively). More deaths


occurred in the PPM group than in the non-PPM group (23 vs 6 deaths; _P_ = 0.003), and PPM patients were also more likely to experience a cardiac event (30 vs 11 patients; _P_ = 0.006). The


authors conclude that PPM has strong predictive value in terms of mortality and cardiac event risk in patients with pure aortic stenosis undergoing AVR. They note that these risks could be


reduced substantially by estimating indexed EOA before prosthesis implantation. Authors * Rebecca Ireland View author publications You can also search for this author inPubMed Google Scholar


RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Ireland, R. Does prosthesis–patient mismatch affect outcome of aortic valve replacement?. _Nat Rev


Cardiol_ 3, 236 (2006). https://doi.org/10.1038/ncpcardio0489 Download citation * Issue Date: 01 May 2006 * DOI: https://doi.org/10.1038/ncpcardio0489 SHARE THIS ARTICLE Anyone you share the


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