Document Detail


Impact of aortic prosthesis-patient mismatch on left ventricular mass regression.
MedLine Citation:
PMID:  24867028     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Prostheses used for aortic valve replacement may be small in relation to body size, causing prosthesis-patient mismatch and delaying left ventricular mass regression. This study examined the effect of prosthesis-patient mismatch on regression of left ventricular mass after aortic valve replacement.
METHODS: We prospectively studied 96 patients undergoing aortic valve replacement between 2007 and 2012. Mean and peak gradients and indexed effective orifice area were measured by transthoracic echocardiography at 3 and 6 months postoperatively. Patient-prosthesis mismatch was defined as indexed effective orifice area ≤0.85 cm(2)·m(-2).
RESULTS: Moderate prosthesis-patient mismatch was present in 25% of patients. There were no significant differences in demographic and operative data between patients with and without prosthesis-patient mismatch. Left ventricular dimensions, posterior wall thickness, transvalvular gradients, and left ventricular mass decreased significantly after aortic valve replacement in both groups. The interventricular septal diameter and left ventricular mass index regression, and left ventricular ejection fraction were better in patients without prosthesis-patient mismatch. There was a significant positive correlation between the postoperative indexed effective orifice area of each valve prosthesis and the rate of left ventricular mass regression.
CONCLUSIONS: Prosthesis-patient mismatch leads to higher transprosthetic gradients and impaired left ventricular mass regression. A small-sized valve prosthesis does not necessarily result in prosthesis-patient mismatch, and may be perfectly adequate in patient with small body size.
Authors:
Mohamed A Alassal; Bedir M Ibrahim; Nabil Elsadeck
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-29
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  22     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2014-5-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  -    
Other Details:
Languages:  ENG     Pagination:  546-550     Citation Subset:  -    
Copyright Information:
© The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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