Document Detail

Influence of prosthesis-patient mismatch on left ventricular remodelling in severe aortic insufficiency.
MedLine Citation:
PMID:  19695896     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The present study evaluates the impact of prosthesis-patient mismatch (PPM) on left ventricular remodelling following aortic valve replacement (AVR) for severe aortic insufficiency.
METHODS: In this study, 230 patients undergoing aortic valve surgery were divided into two groups depending on whether or not they exhibited PPM. Postoperative left ventricular (LV) dimensions and function were compared to the preoperative status.
RESULTS: The incidence of PPM (EOAi <or=0.85 cm(2) m(-2)) was 22.2%. There was no significant difference in the reduction of mean end-diastolic LV diameter (LVEDD; p=0.31) or mean end-systolic LV diameter (LVESD; p=0.79) between the non-PPM and the PPM groups. The LVEDD was reduced in the non-PPM group from 66+/-9 to 55+/-9 mm postoperatively (p<0.001) while the LVEDD in the PPM group was reduced from 65+/-9 to 56+/-10mm (p<0.001). The LVESD was reduced in the non-PPM group from 49+/-10 to 40+/-10mm postoperatively (p<0.001) while the LVESD in the PPM group was reduced from 50+/-11 to 39+/-10mm (p<0.001). Patients with preoperative LV dysfunction (ejection fraction (EF) <50%) demonstrated a significant improvement in postoperative LVEF in both the non-PPM (36+/-8% to 44+/-12%, p<0.001) and PPM groups (33+/-7% to 46+/-11%, p=0.001) but no significant difference could be demonstrated in the rate of improvement between the two groups (p=0.23). Furthermore, no significant difference was found in survival between patients with PPM and those without (p=0.23).
CONCLUSIONS: PPM did not influence left ventricular remodelling or survival following AVR for severe aortic insufficiency. The left ventricular remodelling process was initiated regardless of preoperative LVEF, and the impact of PPM seems to be of little importance.
Shahab Nozohoor; Johan Nilsson; Carsten Lührs; Anders Roijer; Johan Sjögren
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-08-19
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  37     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  133-8     Citation Subset:  IM    
Copyright Information:
Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Department of Cardiothoracic Surgery, Lund University Hospital, Lund, Sweden.
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MeSH Terms
Aged, 80 and over
Aortic Valve Insufficiency / physiopathology,  surgery*
Echocardiography, Doppler, Pulsed / methods
Epidemiologic Methods
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / adverse effects
Middle Aged
Prosthesis Design
Stroke Volume / physiology
Treatment Outcome
Ventricular Dysfunction, Left / physiopathology
Ventricular Remodeling*
Comment In:
Eur J Cardiothorac Surg. 2010 Dec;38(6):814; author reply 514-5   [PMID:  20483630 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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