Incidence and Impact of Patient-Prosthesis Mismatch in Isolated Aortic Valve Surgery

Authors

  • Selman Dumani Service of Cardiac Surgery, University Hospital Center “Mother Theresa”, Tirana
  • Ermal Likaj Service of Cardiac Surgery, University Hospital Center “Mother Theresa”, Tirana
  • Andi Kacani Service of Cardiac Surgery, University Hospital Center “Mother Theresa”, Tirana
  • Laureta Dibra
  • Elizana Petrela Service of Statistics, University Hospital Center “Mother Theresa”, Tirana
  • Vera Beca Obstetrics and Gynecology Hospital “Queen Geraldine”, Tirana
  • Ali Refatllari Service of Cardiac Surgery, University Hospital Center “Mother Theresa”, Tirana

DOI:

https://doi.org/10.3889/oamjms.2015.108

Keywords:

aortic valve, patient-prosthesis mismatch, valve prosthesis

Abstract

AIM: The mains topics of this work are the incidence of patient-prosthesis mismatch and the influence in the early results of isolated aortic valve surgery.

METHODS: In 193 patients isolated aortic valve surgery was performed. The study population was divided in three subgroups: 20 patients with severe, 131 patients with moderate and 42 patients without patient-prosthesis mismatch. The indexed effective orifice area was used to define the subgroups. Operative mortality and perioperative complications were considered the indicators of the early results of aortic valve surgery.

RESULTS: The incidence of severe and moderate patient-prosthesis mismatch was respectively 10.3% and 67.8%. Hospital mortality and perioperative complications were: mortality 5% vs. 3.1% vs. 2.4% (p = 0.855), low cardiac output 5% vs. 6.9% vs. 4.8% (p = 0.861); pulmonary complications 5% vs. 3.1 vs. 0.0% (p = 0.430); exploration for bleeding 5% vs. 0.8% vs. 2.4% (p = 0.319); atrial fibrillation 30% vs. 19.8% vs. 11.9% (p = 0.225); wound infection 5% vs. 0.8% vs. 0.00% (p = 0.165), respectively for the group with severe, moderate and without patient-prosthesis mismatch.

CONCLUSIONS: Patient-prosthesis mismatch is a common occurrence in aortic valve surgery. This phenomenon does not affect the early results of aortic valve surgery.

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References

Rahimtoola ShH. The Problem of Valve Prosthesis-Patient Mismatch. Circulation. 1978;58:20-24.

http://dx.doi.org/10.1161/01.CIR.58.1.20

Pibarot P, Dumesnil JG. Prosthesis-patient mismatch: definition, clinical impact, and prevention. Heart. 2006;92:1022–1029.

http://dx.doi.org/10.1136/hrt.2005.067363

PMid:16251232 PMCid:PMC1861088

Pibarot P, Dumesnil JG. Prosthetic Heart Valves: Selection of the Optimal Prosthesis and Long-Term Management. Circulation. 2009;119 1034-1048

http://dx.doi.org/10.1161/CIRCULATIONAHA.108.778886

PMid:19237674

ATS Medical. ATS open pivot standard heart valve. Effective Orifice Area (EOAI) Calculator.

Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon. European system for cardiac operative risk evaluation (Euro SCORE). Eur J Cardiothoracic Surg. 1999;16:9–13.

http://dx.doi.org/10.1016/S1010-7940(99)00134-7

Bonow RO, Carabello BA, Chatterjee K, de Leon ACJr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. JACC. 2006; 48(3):e1–148.

http://dx.doi.org/10.1016/j.jacc.2006.05.021

PMid:16875962

Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, Borger MA, Carrel TP, De Bonis M, Evangelista A, Falk V, Iung B, Lancellotti P, Pierard L, Price S, Schäfers HJ, Schuler G, Stepinska J, Swedberg K, Takkenberg J, Von Oppell UO, Windecker S, Zamorano JL, Zembala M. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012;33(19):2451-96.

PMid:22922415

Kaminishi Y, Misawa Y, Kobayashi J, Konishi H, Miyata H, Motomura N, Takamoto Sh. Patient- prosthesis mismatch in patients with aortic valve replacement. Gen Thorac Cardiovasc Surg. 2013; 61:274–279.

http://dx.doi.org/10.1007/s11748-013-0216-6

PMid:23404312 PMCid:PMC3641294

Eric Jamieson WR, Ye J Higgins J, Cheung A, Fradet GJ, Skarsgard P, Germann E, Chan F, Lichtenstein S. Effect of Prosthesis-Patient Mismatch on Long-Term Survival With Aortic Valve Replacement: Assessment to 15 Years. V Ann Thorac Surg. 2010;89:51–9.

http://dx.doi.org/10.1016/j.athoracsur.2009.08.070

PMid:20103205

Kobayashi Y, Fukushima Y, Hayase T, Kojima K, Endo G. Clinical Outcome of Aortic Valve Replacement With 16-mm ATS-Advanced Performance Valve for Small Aortic Annulus. Ann Thorac Surg. 2010;89:1195–9.

http://dx.doi.org/10.1016/j.athoracsur.2009.12.074

PMid:20338332

Tasca G, Mhagna Z, Perotti S, Centurini PB, Sabatini T, Amaducci A, Brunelli F, Cirillo M, Dalla Tomba M, Quiani E, Troise G, Pibarot P. Impact of Prosthesis-Patient Mismatch on Cardiac Events and Midterm Mortality After Aortic Valve Replacement in Patients With Pure Aortic Stenosis. Circulation. 2006;113:570-576.

http://dx.doi.org/10.1161/CIRCULATIONAHA.105.587022

PMid:16401767

Howell NJ, Keogh BE, Ray D, Bonser RS, Graham TR Mascaro J, Rooney SJ, Wilson IC, Pagano D. Patient-Prosthesis Mismatch in Patients With Aortic Stenosis Undergoing Isolated Aortic Valve Replacement Does Not Affect Survival. Ann Thorac Surg. 2010;89:60–4.

http://dx.doi.org/10.1016/j.athoracsur.2009.07.037

PMid:20103206

Walther T, Rastan A, Falk V, Lehmann S, Garbade J, Funkat AK, Mohr FW, Gummert JF. Patient prosthesis mismatch affects short- and long-term outcomes after aortic valve replacement European Journal of Cardio-thoracic Surgery. 2006;30:15—19.

http://dx.doi.org/10.1016/j.ejcts.2006.04.007

PMid:16730449

Fuster RG, Montero Argudo JA, Albarova OG,Sos FH, Lopez SC, Codoner MB,Buendıa Minano JA, Albarran IR. Patient-prosthesis mismatch in aortic valve replacement: really tolerable? European Journal of Cardio-thoracic Surgery. 2005;27:441–449.

http://dx.doi.org/10.1016/j.ejcts.2004.11.022

PMid:15740953

Garatti A, Mori F, Innocente F, Canziani A, Gagliardotto P, Mossuto E, Santoro T, Montericcio V, Frigiola A, Menicanti L. Aortic Valve Replacement With 17-mm Mechanical Prostheses: Is Patient–Prosthesis Mismatch a Relevant Phenomenon? Ann Thorac Surg. 2011;91:71– 8.

http://dx.doi.org/10.1016/j.athoracsur.2010.08.036

PMid:21172488

Pisano C, D'Amico T, Palmeri C, Franchino R, Fattouch K, Bianco G, Ruvolo G. Valve prosthesis-patient mismatch: hemodynamic, echocardiographic and clinical consequences. Interactive Cardio Vascular and Thoracic Surgery. 2011;13:606-610.

http://dx.doi.org/10.1510/icvts.2011.283218

PMid:21891800

Hernández-Vaquero D, Llosa JC, Díaz R, Khalpey Z, Morales C, López RAJ, Boye F. Impact of patient-prosthesis mismatch on 30-day outcomes in young and middle-aged patients undergoing aortic valve replacement. Journal of Cardiothoracic Surgery. 2012; 7:46.

http://dx.doi.org/10.1186/1749-8090-7-46

PMid:22587627 PMCid:PMC3428658

Rao V, Eric Jamieson WR, Ivanov J, RN, Armstrong S, David TE. Prosthesis-Patient Mismatch Affects Survival after Aortic Valve Replacement. Circulation. 2000;102:Iii-5-Iii-9.

http://dx.doi.org/10.1161/01.CIR.102.suppl_3.III-5

Hanayama N, Christakis GT, Mallidi HR, Joyner CD, Fremes SE, Christopher D. Morgan CD, R. Mitoff PR, Goldman BS.Patient Prosthesis Mismatch Is Rare After Aortic Valve Replacement: Valve Size May Be Irrelevant. Ann Thorac Surg 2002;73:1822–9.

http://dx.doi.org/10.1016/S0003-4975(02)03582-8

Urso Sa Sadaba R, Aldamiz-Echevarria G Is patient-prosthesis mismatch an independent risk factor for early and mid-term overall mortality in adult patients undergoing aortic valve replacement? Interactive CardioVascular and Thoracic Surgery. 2009;9:510–519.

http://dx.doi.org/10.1510/icvts.2009.207597

PMid:19497953

Published

2014-10-15

How to Cite

1.
Dumani S, Likaj E, Kacani A, Dibra L, Petrela E, Beca V, Refatllari A. Incidence and Impact of Patient-Prosthesis Mismatch in Isolated Aortic Valve Surgery. Open Access Maced J Med Sci [Internet]. 2014 Oct. 15 [cited 2022 Aug. 14];3(4):624-9. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2015.108

Issue

Section

B - Clinical Sciences

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