Prosthesis-patient mismatch after surgical aortic valve replacement in patients with aortic stenosis
- Authors
- Kim, Hee Jung; Kim, Ho Jin; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won
- Issue Date
- Aug-2020
- Publisher
- OXFORD UNIV PRESS
- Keywords
- Patients prosthesis mismatch; Aortic valve replacement; Aortic stenosis
- Citation
- INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, v.31, no.2, pp.152 - 157
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
- Volume
- 31
- Number
- 2
- Start Page
- 152
- End Page
- 157
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/54249
- DOI
- 10.1093/icvts/ivaa085
- ISSN
- 1569-9293
- Abstract
- OBJECTIVES: The issue of prosthesis-patient mismatch (PPM) after surgical aortic valve replacement (SAVR) has been a controversial topic. We sought to evaluate the long-term clinical impacts of PPM in patients undergoing SAVR in an updated, homogeneous cohort. METHODS: Using the prospective institutional database, we identified 895 adult patients (median age 66, interquartile range 58-72; 45.6% women) who underwent isolated SAVR from January 2000 to March 2016. Those with pure aortic insufficiency and concomitant other cardiac operations were excluded from this study cohort. The presence of a significant PPM was defined as an indexed effective orifice area 0.85 cm(2)/m(2) or less. The outcome of interest was all-cause deaths. Propensity score matching was performed for adjusting bias. RESULTS: Significant PPM was present in 247 patients (27.6%). During the follow-up period (mean 71.2 +/- 51.04 months), 134 patients (15%) died. Survival rates at 10 and 15 years were 78.3% vs 83.8% and 71.3% vs 57.6% in the PPM and non-PPM groups (P = 0.972). Risk factor analysis indicated that developing PPM was not associated with a risk of death. After propensity score matching (1:1), developing PPM was not a risk factor for long-term death as well (P = 0.584). CONCLUSIONS: Significant PPM was common after SAVR in patients with aortic stenosis. However, there was no significant difference in survival rate between those with and without PPM.
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