Key result
Moderate PPM complicates ~40% of mechanical AVRs, linked to lower BSA and female gender.
Why the study?
Prosthesis-patient mismatch occurs when an implanted prosthesis is too small relative to body surface area, motivating investigation of its prevalence and the importance of valve size.
What is the prevalence of prosthesis-patient mismatch following mechanical aortic valve replacement, and is it associated with patient body surface area?
Cohort (n=177)
No
What is the prevalence of prosthesis-patient mismatch following mechanical aortic valve replacement, and is it associated with patient body surface area?
Moderate prosthesis-patient mismatch is common after mechanical aortic valve replacement, particularly with single-leaflet valves and in patients with lower body surface area, though short-term functional improvement still occurs.
Moderate PPM after mechanical AVR in low-BSA patients warrants awareness; leaves open impact on long-term outcomes and optimal sizing.
Purpose: Prosthesis -patient mismatch (PPM) occurs when the implanted prosthesis is too small compared to the patient's body surface area (BSA).We analyzed an Aortic Valve Replacement (AVR) study population to investigate PPM prevalence and the importance of aortic valve size.Methods: We conducted a retrospective study of patients aged 18 years and above with isolated aortic valve pathology who underwent AVR with a mechanical prosthetic valve at our center between January 2018 and December 2022. Patients with combined valve pathology and other concomitant surgeries were excluded. EOAi was predicted by calculating patients' BSA and matching to the valve -specific EOAi calculator. Results: Of the 177 patients with isolated mechanical AVR included in this study, PPM was not observed in 106 patients, while 71 patients had moderate PPM. All valves with moderate PPM were single leaflets, and 71% had PPM. The patients' age and BSA were significantly associated with the valve size. Also, BSA was substantially lower in subjects having PPM (p = 0.025). Conclusions: PPM after aortic valve replacement is associated with higher post -operative morbidity and mortality. Despite more frequent PPM experienced by patients with single -leaflet mechanical valves, the clinical conditions of all patients in our study improved with no negative immediate post -operative outcomes. We propose confirming the EAOi chart before implanting single leaflet mechanical valves and a longer follow -up period for the patients' best interests.
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Prasad et al. (2023) conducted a cohort in Isolated aortic valve pathology (n=177). Mechanical prosthetic aortic valve replacement was evaluated on Moderate prosthesis-patient mismatch (PPM). Moderate prosthesis-patient mismatch occurred in 40% of patients following mechanical aortic valve replacement and was significantly associated with lower body surface area and female gender.
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