Patient-Prosthesis Mismatch After Aortic Valve Replacement

Wauthy, Pierre; Malekzadeh‐Milani, Sophie

doi:10.5772/19223

Cited by 2 publications

(2 citation statements)

References 34 publications

(42 reference statements)

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“…37 Many studies have suggested the following steps for avoiding PPM. [38][39][40][41] Firstly, the patients' BSA should be calculated to find the valve with a greater projected EOA. If other valves are not available, mechanical prosthesis or an aortic homograft should be considered.…”

Section: Discussionmentioning

confidence: 99%

Early outcomes of patient-prosthesis mismatch following aortic valve replacement

et al. 2021

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Introduction: Patient-prosthesis mismatch (PPM) has been associated with numerous short- and long-term adverse events. This study aimed to evaluate the effect of PPM on early postoperative results after aortic valve replacement (AVR) in daily practice. Methods: In this single-centre retrospective study, 150 non-consecutive patients from March 2019 to January 2020 with clinically indicated AVR with/without concomitant surgery were analysed. The study protocol included operative mortality, complication rate, and pre- and postoperative echocardiographic data. PPM was considered severe with indexed effective orifice area at <0.65 cm2/m2, moderate at 0.65–0.85 cm2/m2 and none at >0.85 cm2/m2. Results: Moderate PPM was observed in 16 patients (10.6%). No patient had severe PPM. PPM was not related to early mortality ( r = 0.40, p = 0.630), intra- ( r = −0.076, p = 0.352) and postoperative ( r = −0.0134, p = 0.102) events. Conclusion: In this study, moderate PPM was a frequent finding after AVR, whereas severe PPM was not observed. PPM did not affect the early results after AVR. A long-term follow-up study in a large patient population is required to assess the actual influence of residual PPM.

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Section: Discussionmentioning

confidence: 99%

Early outcomes of patient-prosthesis mismatch following aortic valve replacement

et al. 2021

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“…According to our data, the absolute number of PPM patients decreased after the physical exercise test. This can be explained by the hydraulic equation G = Q 2 /(k × EOA 2 ), where G is the gradient, Q is the flow, and k is a constant [25]. Because of unchanged transprosthetic gradients before and immediately after exercise and the high flow (high cardiac output) after exercise, EOA increased and the PPM rate decreased.…”

Section: Ppm Ratementioning

confidence: 99%

Early Hemodynamics after Aortic Valve Replacement

et al. 2020

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Background and objectives: The aims of this study were to investigate changes in the hemodynamics associated with different types of aortic prostheses and to evaluate patient-prosthesis mismatch (PPM) at rest and after exercise. Materials and Methods: We retrospectively analyzed 150 patients who presented with indications for aortic valve replacement (AVR) with/without concomitant surgery from March 2019 to January 2020. The study population included 90 (60%) men and 60 (40%) women (mean age, 67.33 ± 10.22 years; range, 37–88 years). Echocardiography data such as peak and mean transprosthetic pressure gradients (Gmax, Gmean), velocity (V), effective orifice area (EOA), and indexed EOA (iEOA) were derived at rest and after exercise at baseline and before discharge. The study patients performed the six-minute walk test (6MWT) on the 5th–7th postoperative day. Results: Stented tissue valves showed excellent performance at rest and after exercise in comparison with mechanical valves, which showed favorable hemodynamics at rest only. At the time of discharge, moderate PPM was observed in 7/74 patients (9.5%) at rest and 5/98 (3.3%) patients after exercise. None of the patients showed severe PPM. EOA and iEOA were not significantly different between the groups. However, the stented group showed more pronounced changes in EOA and iEOA after exercise, whereas the changes in the mechanical valve group did not reach significance. Conclusions: In the early postoperative period, mechanical valves and stented valves showed favorable resting hemodynamics. The PPM rate measured after exercise was lower than that at rest.

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Patient-Prosthesis Mismatch After Aortic Valve Replacement

Cited by 2 publications

References 34 publications

Early outcomes of patient-prosthesis mismatch following aortic valve replacement

Early outcomes of patient-prosthesis mismatch following aortic valve replacement

Early Hemodynamics after Aortic Valve Replacement

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