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Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China

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...

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Autores principales: Guo, Lei, Zheng, Junnan, Chen, Liangwei, Li, Renyuan, Ma, Liang, Ni, Yiming, Zhao, Haige
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445281/
https://www.ncbi.nlm.nih.gov/pubmed/28545592
http://dx.doi.org/10.1186/s13019-017-0596-2
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author Guo, Lei
Zheng, Junnan
Chen, Liangwei
Li, Renyuan
Ma, Liang
Ni, Yiming
Zhao, Haige
author_facet Guo, Lei
Zheng, Junnan
Chen, Liangwei
Li, Renyuan
Ma, Liang
Ni, Yiming
Zhao, Haige
author_sort Guo, Lei
collection PubMed
description 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 cm(2)/m(2). 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.
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spelling pubmed-54452812017-05-30 Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China Guo, Lei Zheng, Junnan Chen, Liangwei Li, Renyuan Ma, Liang Ni, Yiming Zhao, Haige J Cardiothorac Surg Research Article 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 cm(2)/m(2). 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. BioMed Central 2017-05-25 /pmc/articles/PMC5445281/ /pubmed/28545592 http://dx.doi.org/10.1186/s13019-017-0596-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Guo, Lei
Zheng, Junnan
Chen, Liangwei
Li, Renyuan
Ma, Liang
Ni, Yiming
Zhao, Haige
Impact of prosthesis–patient mismatch on short-term outcomes after aortic valve replacement: a retrospective analysis in East China
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 Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445281/
https://www.ncbi.nlm.nih.gov/pubmed/28545592
http://dx.doi.org/10.1186/s13019-017-0596-2
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