Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China
Abstract Background Prosthesis–patient mismatch (PPM) may affect the clinical outcomes of patients undergoing aortic valve replacement (AVR). We aimed to determine the incidence of PPM, its effect on short-term mortality, and the factors contributing to PPM in China. Methods We retrospectively exami...
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s13019-017-0596-2 |
| _version_ | 1818759754766352384 |
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| author | Lei Guo Junnan Zheng Liangwei Chen Renyuan Li Liang Ma Yiming Ni Haige Zhao |
| author_facet | Lei Guo Junnan Zheng Liangwei Chen Renyuan Li Liang Ma Yiming Ni Haige Zhao |
| author_sort | Lei Guo |
| collection | DOAJ |
| description | Abstract Background Prosthesis–patient mismatch (PPM) may affect the clinical outcomes of patients undergoing aortic valve replacement (AVR). We aimed to determine the incidence of PPM, its effect on short-term mortality, and the factors contributing to PPM in China. Methods We retrospectively examined all consecutive patients with isolated or concomitant AVR at our hospital between January 1, 2013 and December 31, 2015. PPM was defined as an effective orifice area index (EOAi) of ≤ 0.85 cm2/m2. The baseline, echocardiographic, operative, and outcome data of all patients were collected from the national database. Results A total of 869 patients were included in the study. PPM was detected in 15.9% (138/869) of the patients. Four patients (0.5%) met the criteria for severe PPM. Patients with PPM were older and had a higher prevalence of diabetes, coronary heart disease, aortic stenosis (AS), and preoperative left ventricular dysfunction but a lower incidence of smoking history and aortic regurgitation. Logistic regression analysis showed that female gender (P < 0.001), AS (P = 0.014), higher body mass index (BMI) (P < 0.001), and bioprosthesis (P < 0.001) were independent predictors of PPM. We also found that PPM (P = 0.005) was associated with 30-day all-cause mortality, along with smoking history (P = 0.001) and low preoperative left ventricular ejection fraction (LVEF) (P = 0.004). Conclusions PPM is associated with high short-term mortality after AVR in China. Female gender, aortic stenosis, bioprosthesis, and high BMI are risk factors for the incidence of PPM. |
| first_indexed | 2024-12-18T06:47:45Z |
| format | Article |
| id | doaj.art-b7d5b08c42254281a4290890855a133c |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-18T06:47:45Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-b7d5b08c42254281a4290890855a133c2022-12-21T21:17:26ZengBMCJournal of Cardiothoracic Surgery1749-80902017-05-011211610.1186/s13019-017-0596-2Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East ChinaLei Guo0Junnan Zheng1Liangwei Chen2Renyuan Li3Liang Ma4Yiming Ni5Haige Zhao6Department of Thoracic and Cardiovascular Surgery, First Affiliated Hospital of Zhejiang University, School of MedicineDepartment of Thoracic and Cardiovascular Surgery, First Affiliated Hospital of Zhejiang University, School of MedicineDepartment of Thoracic and Cardiovascular Surgery, First Affiliated Hospital of Zhejiang University, School of MedicineDepartment of Thoracic and Cardiovascular Surgery, First Affiliated Hospital of Zhejiang University, School of MedicineDepartment of Thoracic and Cardiovascular Surgery, First Affiliated Hospital of Zhejiang University, School of MedicineDepartment of Thoracic and Cardiovascular Surgery, First Affiliated Hospital of Zhejiang University, School of MedicineDepartment of Thoracic and Cardiovascular Surgery, First Affiliated Hospital of Zhejiang University, School of MedicineAbstract Background Prosthesis–patient mismatch (PPM) may affect the clinical outcomes of patients undergoing aortic valve replacement (AVR). We aimed to determine the incidence of PPM, its effect on short-term mortality, and the factors contributing to PPM in China. Methods We retrospectively examined all consecutive patients with isolated or concomitant AVR at our hospital between January 1, 2013 and December 31, 2015. PPM was defined as an effective orifice area index (EOAi) of ≤ 0.85 cm2/m2. The baseline, echocardiographic, operative, and outcome data of all patients were collected from the national database. Results A total of 869 patients were included in the study. PPM was detected in 15.9% (138/869) of the patients. Four patients (0.5%) met the criteria for severe PPM. Patients with PPM were older and had a higher prevalence of diabetes, coronary heart disease, aortic stenosis (AS), and preoperative left ventricular dysfunction but a lower incidence of smoking history and aortic regurgitation. Logistic regression analysis showed that female gender (P < 0.001), AS (P = 0.014), higher body mass index (BMI) (P < 0.001), and bioprosthesis (P < 0.001) were independent predictors of PPM. We also found that PPM (P = 0.005) was associated with 30-day all-cause mortality, along with smoking history (P = 0.001) and low preoperative left ventricular ejection fraction (LVEF) (P = 0.004). Conclusions PPM is associated with high short-term mortality after AVR in China. Female gender, aortic stenosis, bioprosthesis, and high BMI are risk factors for the incidence of PPM.http://link.springer.com/article/10.1186/s13019-017-0596-2Prosthesis–patient mismatch (PPM)Aortic valve replacement (AVR)Aortic stenosis (AS)Effective orifice area (EOA) |
| spellingShingle | Lei Guo Junnan Zheng Liangwei Chen Renyuan Li Liang Ma Yiming Ni Haige Zhao Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China Journal of Cardiothoracic Surgery Prosthesis–patient mismatch (PPM) Aortic valve replacement (AVR) Aortic stenosis (AS) Effective orifice area (EOA) |
| title | Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China |
| title_full | Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China |
| title_fullStr | Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China |
| title_full_unstemmed | Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China |
| title_short | Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China |
| title_sort | impact of prosthesis patient mismatch on short term outcomes after aortic valve replacement a retrospective analysis in east china |
| topic | Prosthesis–patient mismatch (PPM) Aortic valve replacement (AVR) Aortic stenosis (AS) Effective orifice area (EOA) |
| url | http://link.springer.com/article/10.1186/s13019-017-0596-2 |
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