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Does prosthetic valve size affect postoperative Duke Activity Status Index (DASI) score after aortic valve replacement?
Does prosthetic valve size affect postoperative Duke Activity Status Index (DASI) score after aortic valve replacement?
This editorial highlights that while functional status improves after AVR, prosthetic valve size alone may not correlate with postoperative DASI scores, though the lack of echocardiographic data limits conclusions on prosthesis-patient mismatch.
In this issue of Circulation, Koch and associates1 from theCleveland Clinic published a study on the relationshipbetween prosthetic valve size and the Duke Activity Status Index (DASI) after aortic valve replacement (AVR). The study was conducted with 1014 patients operated on from 1995 through 1998, completed 1 year later, and pub-lished now. DASI scores increased from a mean of 29 preoperatively to 46 postoperatively after a mean follow-up of 8.3 months. The investigators could find no obvious relationship between prosthetic valve size and postoperative DASI score. One of the limitations of the study was that prosthetic valve gradients and effective orifice areas were not measured by echocardiography to quantify prosthesis–patient mismatch. It is also interesting to note that more than two thirds of the patients were in New York Heart Association functional classes I and II preoperatively, and yet the DASI mean score before surgery was only 29 out of a maximum of
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Tirone E. David (2005) studied this question.
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