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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900404/ https://www.ncbi.nlm.nih.gov/pubmed/26750679 http://dx.doi.org/10.4103/0971-9784.173025 |
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author | Joshi, Shreedhar S. Ashwini, T. George, Antony Jagadeesh, A. M. |
author_facet | Joshi, Shreedhar S. Ashwini, T. George, Antony Jagadeesh, A. M. |
author_sort | Joshi, Shreedhar S. |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-4900404 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-49004042016-06-16 Patient prosthesis mismatch after aortic valve replacement: An Indian perspective Joshi, Shreedhar S. Ashwini, T. George, Antony Jagadeesh, A. M. Ann Card Anaesth Original Article: Janak Mehta Award 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. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4900404/ /pubmed/26750679 http://dx.doi.org/10.4103/0971-9784.173025 Text en Copyright: © 2016 Annals of Cardiac Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article: Janak Mehta Award Joshi, Shreedhar S. Ashwini, T. George, Antony Jagadeesh, A. M. Patient prosthesis mismatch after aortic valve replacement: An Indian perspective |
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 | Original Article: Janak Mehta Award |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900404/ https://www.ncbi.nlm.nih.gov/pubmed/26750679 http://dx.doi.org/10.4103/0971-9784.173025 |
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