Key result
Significant PPM after AVR is linked to ~56% less LVMi regression than insignificant mismatch.
Why the study?
Previous studies on patient-prosthesis mismatch (PPM) have not comprehensively addressed its effect on left ventricular hypertrophy regression, geometry alterations, and symptom improvement after surgical aortic valve replacement.
Does significant patient-prosthesis mismatch affect left ventricular mass index regression and functional capacity in patients undergoing surgical aortic valve replacement for severe aortic stenosis?
Cohort (n=91)
No
Does significant patient-prosthesis mismatch affect left ventricular mass index regression and functional capacity in patients undergoing surgical aortic valve replacement for severe aortic stenosis?
Avoiding significant patient-prosthesis mismatch after surgical aortic valve replacement leads to better regression of left ventricular mass index and improved functional capacity, though it does not significantly alter left ventricular geometry.
Background: This study aimed to investigate the effects of patient-prosthesis mismatch (PPM) on left ventricular structure and functional capacity in patients undergoing isolated surgical aortic valve replacement (sAVR) for severe aortic stenosis. Methods: This retrospective analysis included preoperative and postoperative data of 157 consecutive patients who underwent isolated sAVR between January 2016 and January 2023. Body mass index and indexed effective orifice area were calculated. The severity of PPM was assessed using the valve academic research consortium-3 criteria, and patients were categorized into (1) Insignificant PPM and (2) Significant PPM. Left ventricular geometries were classified based on the left ventricular mass index (LVMi) and relative wall thickness. Functional capacity was evaluated according to the New York Heart Association classification. Results: in the significant PPM group (p=0.037). Multivariate logistic regression demonstrated a significant association between LVMi change and significant PPM (odds ratio: 1.021, p=0.043). Although no significant change was observed in left ventricular geometry in either the groups, a significant difference was noted in the functional capacity changes (p=0.01). Conclusion: Avoiding significant PPM provides better regression in LVMi and greater improvement in functional capacity; however, it is not sufficient for a significant change in left ventricular geometr y.
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Ayyıldız et al. (2026) conducted a cohort in Severe aortic stenosis (n=91). Significant patient-prosthesis mismatch vs. Insignificant patient-prosthesis mismatch was evaluated on Change in left ventricular mass index (LVMi) (OR 1.021, 95% CI 1.001-1.041, p=0.043). Significant patient-prosthesis mismatch after aortic valve replacement resulted in less regression of left ventricular mass index (median -14.5 vs -33 g/m2, p=0.037) than insignificant mismatch.
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