Severe patient-prosthesis mismatch did not significantly affect 5-year survival compared to no mismatch (83% vs 81%; p=0.47) following aortic valve replacement.
Cohort (n=1,418)
No
Does severe patient-prosthesis mismatch reduce survival in patients undergoing aortic valve replacement?
Severe patient-prosthesis mismatch following aortic valve replacement does not appear to negatively impact in-hospital mortality or mid-term survival.
Absolute Event Rate: 83% vs 81%
p-value: p=0.47
OBJECTIVE: Patient-prosthesis mismatch (PPM) has been reported to increase perioperative mortality and reduce postoperative survival in patients undergoing aortic valve replacement (AVR). We analysed the effect of PPM at values predicting severe mismatch on survival following AVR in our unit. METHODS: Prospectively collected data on 1481 consecutive patients who had undergone AVR with or without coronary artery revascularisation between 1997 and 2005 were analysed. Projected in vitro valve effective orifice area (EOA) and geometric prosthesis internal orifice area (GOA) were evaluated and values were indexed to body surface area (cm(2)m(-2)). PPM was defined as EOAi80, RR 2.13, 95% CI 1.38-4.586, p=0.004). CONCLUSIONS: Severe patient-prosthesis mismatch was predicted in 4-10% of patients undergoing AVR but this did not affect in-hospital mortality or mid-term survival.
Howell et al. (2006) conducted a cohort in Aortic valve replacement (n=1,418). Patient-prosthesis mismatch (PPM) vs. No mismatch was evaluated on 5-year survival (p=0.47). Severe patient-prosthesis mismatch did not significantly affect 5-year survival compared to no mismatch (83% vs 81%; p=0.47) following aortic valve replacement.