Clinical outcome in patients with 19-mm and 21-mm St. Jude aortic prostheses: comparison at long-term follow-up

Impact of Valve Prosthesis-Patient Mismatch on Short-Term Mortality After Aortic Valve Replacement

“…However, short-term mortality was not analyzed nor was left ventricular function taken into account. Nonetheless, when considered collectively, these previous studies 6,7,10,11 might indirectly suggest that the greatest impact of PPM with regards to survival is in the early postoperative period when the left ventricle is most vulnerable. Our results also suggest that there could be a natural selection process at that time of operation during which many patients at risk do not survive beyond the early postoperative period, which in turn could explain the relatively better prognosis of moderate-severe PPM beyond that critical period.…”

“…However, in the latter study, no distinction was made between patients with and without left ventricular dysfunction and in vitro rather than in vivo values were used to calculate the indexed EOA, resulting in potentially higher values for indexed EOA. 2,4 The indexed valve EOA was also used by Milano et al 6 to analyze the influence of PPM in patients undergoing AVR. As in a previous study from our laboratory, 7 these authors identified severe PPM as an independent predictor of late cardiac events but not of late mortality.…”

Impact of Prosthesis–Patient Size on Functional Recovery After Aortic Valve Replacement

“…Patients defined as having prosthesis-patient size mismatch are reported to be at increased risk for short-2,15,17 and long-2 term mortality, deterioration in hemodynamic variables, 13,17 exercise-induced increases in mean transvalvular pressure gradients approaching mild to moderate degrees of aortic stenosis, 14 reduced exercise tolerance, 18 and less extensive regression of left ventricular hypertrophy. 19,20 Prosthesis-patient mismatch has been reported to be an independent predictor for postoperative congestive heart failure 21 and has been associated with higher postoperative New York Heart Association (NYHA) functional class. [17][18][19] Furthermore, those with mismatch reportedly have a higher occurrence of postoperative syncope, pulmonary edema, and angina.…”

Patient-Prosthesis Mismatch After Aortic Valve Replacement

“…Patient-prosthesis mismatch has several major clinical impacts described below and these impacts increase proportionally with the severity of PPM (Blais et al, 2003, Milano et al, 2002. It is thus important to quantify the severity of this hemodynamic situation.…”

“…Using the indexed in vivo EOA, PPM in not infrequent. Prevalence of moderate PPM varies in the literature from 20 to 70% and severe PPM prevalence is estimated between 2 to 11% , Blais et al, 2003, Milano et al, 2002, Tasca et al, 2005. The PPM prediction at the time of surgery is a key issue.…”