Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China

BACKGROUND: Prosthesis-patient mismatch (PPM) may affect the clinical outcomes of patients undergoing aortic valve replacement (AVR). We aimed to determine the incidence of PPM, its effect on short-term mortality, and the factors contributing to PPM in China. METHODS: . The baseline, echocardiographic, operative, and outcome data of all patients were collected from the national database. RESULTS: A total of 869 patients were included in the study. PPM was detected in 15.9% (138/869) of the patients. Four patients (0.5%) met the criteria for severe PPM. Patients with PPM were older and had a higher prevalence of diabetes, coronary heart disease, aortic stenosis (AS), and preoperative left ventricular dysfunction but a lower incidence of smoking history and aortic regurgitation. Logistic regression analysis showed that female gender (P < 0.001), AS (P = 0.014), higher body mass index (BMI) (P < 0.001), and bioprosthesis (P < 0.001) were independent predictors of PPM. We also found that PPM (P = 0.005) was associated with 30-day all-cause mortality, along with smoking history (P = 0.001) and low preoperative left ventricular ejection fraction (LVEF) (P = 0.004). CONCLUSIONS: PPM is associated with high short-term mortality after AVR in China. Female gender, aortic stenosis, bioprosthesis, and high BMI are risk factors for the incidence of PPM.