Language
English
Publication Date
9-1-2023
Journal
The Texas Heart Institute Journal
DOI
10.14503/THIJ-22-8048
PMCID
PMC10658167
PubMedCentral® Posted Date
10-23-2023
PubMedCentral® Full Text Version
Post-Print
Abstract
BACKGROUND: Patient-prosthesis mismatch (PPM) may impair functional capacity and survival after aortic valve replacement. This study aimed to investigate the impact of PPM on long-term survival and quality of life after mechanical and biological aortic valve replacement.
METHODS: This study included 595 consecutive patients who had undergone isolated aortic valve replacement. Patients were divided into 2 groups according to prosthesis type. The baseline and operative characteristics, survival rates, complications, and quality of life of the groups with and without PPM were compared for up to 6 years. The PPM calculation was performed using the effective orifice area value provided by the manufacturer divided by the patient's body surface area.
RESULTS: The moderate to severe PPM rates were 69.8% and 3.7% after biological and mechanical prosthesis implantation, respectively. Mean survival for patients in the biological group who had PPM was statistically significantly shorter (50.2 months [95% CI, 45.2-55.3]) than for patients in the biological group without PPM (60.1 months [95% CI, 55.7-64.4]; P = .04). In the mechanical prosthesis group, there was no difference in mean survival between the subgroup with PPM (66.6 months [95% CI, 58.3-74.9]) and the subgroup without PPM (64.9 months [95% CI, 62.6-67.2]; P = .50). A quality-of-life questionnaire's scores did not differ between the groups.
CONCLUSION: Mismatch is common after biological valve implantation and statistically significantly affects long-term survival and quality of life. If the risk of PPM after implantation of a biological prosthesis is suspected, adopting strategies to avoid PPM at the time of surgery is warranted.
Keywords
Patient outcome assessment, quality of life, heart valve prosthesis implantation, bioprosthesis, aortic valve disease
Published Open-Access
yes
Recommended Citation
Matkovic, Milos; Aleksic, Nemanja; Bilbija, Ilija; et al., "Clinical Impact of Patient-Prosthesis Mismatch After Aortic Valve Replacement With a Mechanical or Biological Prosthesis" (2023). The Texas Heart Institute Journal. 146.
https://digitalcommons.library.tmc.edu/texasheartinstituejournal/146