Patient prosthesis mismatch after aortic valve replacement: An Indian perspective

Context: Perioperative period. Aims: Occurrence of PPM after AVR, factors associated with PPM, impact on mortality. Settings and Design: Teritary Care Referral Cardiac Centre. Materials and Methods: A retrospective analysis of AVR procedures at a single centre over 4 years was conducted. Demographic...

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Main Authors: Shreedhar S Joshi, T Ashwini, Antony George, A M Jagadeesh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Annals of Cardiac Anaesthesia
Subjects:
Online Access:http://www.annals.in/article.asp?issn=0971-9784;year=2016;volume=19;issue=1;spage=84;epage=88;aulast=Joshi
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author Shreedhar S Joshi
T Ashwini
Antony George
A M Jagadeesh
author_facet Shreedhar S Joshi
T Ashwini
Antony George
A M Jagadeesh
author_sort Shreedhar S Joshi
collection DOAJ
description Context: Perioperative period. Aims: Occurrence of PPM after AVR, factors associated with PPM, impact on mortality. Settings and Design: Teritary Care Referral Cardiac Centre. Materials and Methods: A retrospective analysis of AVR procedures at a single centre over 4 years was conducted. Demographic, echocardiographic and outcome data were collected from institute database. Rahimtoola criteria of indexed effective orifice area (iEOA) were used to stratify patients into PPM categories. Patients with and without PPM were compared for associated factors. Statistical Analysis Used: Independent t-test, chi-square test, logistic regression analysis, ROC-AUC, Youden index. Results: 606 patients with complete data were analysed for PPM. The incidence of mild, moderate and severe PPM was 6.1% (37), 2.5% (15) and 0.5% (3) respectively. There was no impact of PPM on all-cause in-hospital mortality. PPM was observed more with Aortic Stenosis (AS) compared to Aortic Regurgitation (AR) as etiology. Aortic annulus indexed to BSA (iAA) had a very good predictive ability for PPM at <16mm/m 2 BSA. Conclusions: PPM has lower incidence after AVR in this Indian population and does not increase early mortality. Patients with AS and iAA<16mm/m2BSA should be cautiously dealt with to prevent PPM.
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spelling doaj.art-0480fbde310247b7a5361b68ceb5e2f22022-12-21T17:34:19ZengWolters Kluwer Medknow PublicationsAnnals of Cardiac Anaesthesia0971-97842016-01-01191848810.4103/0971-9784.173025Patient prosthesis mismatch after aortic valve replacement: An Indian perspectiveShreedhar S JoshiT AshwiniAntony GeorgeA M JagadeeshContext: Perioperative period. Aims: Occurrence of PPM after AVR, factors associated with PPM, impact on mortality. Settings and Design: Teritary Care Referral Cardiac Centre. Materials and Methods: A retrospective analysis of AVR procedures at a single centre over 4 years was conducted. Demographic, echocardiographic and outcome data were collected from institute database. Rahimtoola criteria of indexed effective orifice area (iEOA) were used to stratify patients into PPM categories. Patients with and without PPM were compared for associated factors. Statistical Analysis Used: Independent t-test, chi-square test, logistic regression analysis, ROC-AUC, Youden index. Results: 606 patients with complete data were analysed for PPM. The incidence of mild, moderate and severe PPM was 6.1% (37), 2.5% (15) and 0.5% (3) respectively. There was no impact of PPM on all-cause in-hospital mortality. PPM was observed more with Aortic Stenosis (AS) compared to Aortic Regurgitation (AR) as etiology. Aortic annulus indexed to BSA (iAA) had a very good predictive ability for PPM at <16mm/m 2 BSA. Conclusions: PPM has lower incidence after AVR in this Indian population and does not increase early mortality. Patients with AS and iAA<16mm/m2BSA should be cautiously dealt with to prevent PPM.http://www.annals.in/article.asp?issn=0971-9784;year=2016;volume=19;issue=1;spage=84;epage=88;aulast=JoshiAortic annulus indexed to body surface area; Aortic valve replacement; Patient prosthesis mismatch
spellingShingle Shreedhar S Joshi
T Ashwini
Antony George
A M Jagadeesh
Patient prosthesis mismatch after aortic valve replacement: An Indian perspective
Annals of Cardiac Anaesthesia
Aortic annulus indexed to body surface area; Aortic valve replacement; Patient prosthesis mismatch
title Patient prosthesis mismatch after aortic valve replacement: An Indian perspective
title_full Patient prosthesis mismatch after aortic valve replacement: An Indian perspective
title_fullStr Patient prosthesis mismatch after aortic valve replacement: An Indian perspective
title_full_unstemmed Patient prosthesis mismatch after aortic valve replacement: An Indian perspective
title_short Patient prosthesis mismatch after aortic valve replacement: An Indian perspective
title_sort patient prosthesis mismatch after aortic valve replacement an indian perspective
topic Aortic annulus indexed to body surface area; Aortic valve replacement; Patient prosthesis mismatch
url http://www.annals.in/article.asp?issn=0971-9784;year=2016;volume=19;issue=1;spage=84;epage=88;aulast=Joshi
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AT tashwini patientprosthesismismatchafteraorticvalvereplacementanindianperspective
AT antonygeorge patientprosthesismismatchafteraorticvalvereplacementanindianperspective
AT amjagadeesh patientprosthesismismatchafteraorticvalvereplacementanindianperspective