Background: Previous studies have shown that prosthesis-patient mismatch (PPM) results in higher early and late mortality after bioprosthetic aortic valve replacement. Careful selection of stented bioprostheses was recommended to avoid inadequate effective orifice area. We studied the incidence of PPM and its potential effects on clinical outcome in patients undergoing aortic valve replacement using the Carpentier-Edwards Perimount bioprosthesis.
Methods: Independent predictors of early and late mortality and hospital readmission for cardiac reasons were defined in 506 patients (mean age, 73 years; range, 57 to 87 years) by multivariate analysis. Mean follow-up was 6.1 +/- 4.8 years; maximum follow-up was 18.6 years.
Results: The incidence of severe PPM (effective orifice area index < 0.65 cm2/m2) was 0.2% and of moderate PPM (effective orifice area index > 0.65 and < 0.85) was 20%. Multivariate analysis revealed that moderate PPM was not an independent predictor of early mortality, late mortality, or hospital readmission for cardiac reasons. Reduction of septal hypertrophy was similar in patients with and without moderate PPM.
Conclusions: The incidence of severe PPM is virtually nonexistent after aortic valve replacement using the Carpentier-Edwards Perimount valve. Moderate PPM is found in 20% of cases and is clinically irrelevant in this population.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.athoracsur.2006.03.089 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Platelet Volume Parameters as Predictors of Valvular Thrombosis Risk in Patients with Aortic and Mitral Valve Replacement.
Clin Appl Thromb Hemost
January 2025
Cardiovascular Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Percutaneous valve implantation or surgical replacement with mechanical or biological valves are standard therapies for severe valvular heart diseases. Prosthetic valve thrombosis, though rare, is a serious complication, particularly with mechanical prostheses. This study aimed to investigate the predictive value of platelet volume parameters, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR), for valvular thrombosis risk in patients undergoing valve replacement therapy.
View Article and Find Full Text PDFAortic Valve Plasty for Coexistence of Discrete Subvalvular Aortic Stenosis and Quadricuspid Aortic Valve: A Case Report.
Cureus
December 2024
Cardiovascular Surgery, Ayase Heart Hospital, Tokyo, JPN.
Subvalvular aortic stenosis typically manifests at a young age and rarely presents in adulthood. It may cause left ventricular outflow tract stenosis, which requires surgical treatment in severe cases. The coexistence of discrete subvalvular aortic stenosis and quadricuspid aortic valve is a highly unusual finding.
View Article and Find Full Text PDFA Case of a Newborn Presenting With a VACTERL-Like Association.
Cureus
December 2024
Family Medicine, Louisiana State University Health Sciences Center, Alexandria, USA.
The VACTERL (vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities) association represents an enigmatic syndrome requiring further study. This report describes a full-term neonate born to a multiparous woman who was found, upon further examination, to have multiple congenital abnormalities, including a bicuspid aortic valve, patent foramen ovale, tracheoesophageal fistula (TEF), asymmetric crying facies, microphallus, and a single inguinal testis. The discussion explores environmental and genetic factors that may contribute to this association, as well as similar conditions, such as CHARGE (coloboma, heart defects, choanal atresia, growth retardation, genital abnormalities, and ear abnormalities) syndrome.
View Article and Find Full Text PDFY Incision and Roof Technique for Aortic Root Enlargement: A Minimally Invasive Approach.
Ann Thorac Surg Short Rep
September 2023
Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
The Y incision and roof technique for aortic valve replacement enable implantation of a large prosthetic valve and extensive enlargement of the sinotubular junction. Surgeons have been reluctant to adopt a minimally invasive approach for this procedure because of its complexity and risk. The Stonehenge technique was designed to achieve an ideal surgical view of the aortic root through a small right thoracotomy.
View Article and Find Full Text PDFFour-Dimensional Flow Magnetic Resonance Imaging Evaluation of Post-Ross David Procedure With Valve Repair.
Ann Thorac Surg Short Rep
September 2023
Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Valve-sparing aortic root replacements have acceptable reintervention rates in patients with failed pulmonary autografts after a Ross procedure. In our 50-year-old patient with post-Ross valve-sparing aortic root replacement, we report preoperative and postoperative 4-dimensional flow magnetic resonance imaging capturing changes in peak systolic velocity, 3-dimensional systolic flow profiles, and aortic wall shear stress that may predict a decreased risk of aortic dilation, a common complication in repeated Ross procedures.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!