Document Detail


Prosthesis-patient mismatch is not clinically relevant in aortic valve replacement using the Carpentier-Edwards Perimount valve.
MedLine Citation:
PMID:  16863756     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have shown that prosthesis-patient mismatch (PPM) results in higher early and late mortality after bioprosthetic aortic valve replacement. Careful selection of stented bioprostheses was recommended to avoid inadequate effective orifice area. We studied the incidence of PPM and its potential effects on clinical outcome in patients undergoing aortic valve replacement using the Carpentier-Edwards Perimount bioprosthesis. METHODS: Independent predictors of early and late mortality and hospital readmission for cardiac reasons were defined in 506 patients (mean age, 73 years; range, 57 to 87 years) by multivariate analysis. Mean follow-up was 6.1 +/- 4.8 years; maximum follow-up was 18.6 years. RESULTS: The incidence of severe PPM (effective orifice area index < 0.65 cm2/m2) was 0.2% and of moderate PPM (effective orifice area index > 0.65 and < 0.85) was 20%. Multivariate analysis revealed that moderate PPM was not an independent predictor of early mortality, late mortality, or hospital readmission for cardiac reasons. Reduction of septal hypertrophy was similar in patients with and without moderate PPM. CONCLUSIONS: The incidence of severe PPM is virtually nonexistent after aortic valve replacement using the Carpentier-Edwards Perimount valve. Moderate PPM is found in 20% of cases and is clinically irrelevant in this population.
Authors:
Willem Flameng; Bart Meuris; Paul Herijgers; Marie-Christine Herregods
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  82     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-25     Completed Date:  2006-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  530-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, University Clinic Gasthuisberg, Leuven, Belgium. willem.flameng@med.kuleuven.be
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve / surgery*
Bioprosthesis*
Echocardiography
Female
Follow-Up Studies
Heart Valve Prosthesis / adverse effects*
Heart Valve Prosthesis Implantation / mortality*
Humans
Hypertrophy, Left Ventricular / therapy
Male
Middle Aged
Prosthesis Fitting

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


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