Factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.

<h4>Objective</h4>"Patient-prosthesis mismatch" (PPM) after aortic valve replacement (AVR) has been reported to increase morbidity and mortality. Although algorithms have been developed to avoid PPM, factors favouring its occurrence have not been well defined.<h4>Design a...

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Autores principales:	Diana Bonderman, Alexandra Graf, Andreas A Kammerlander, Alfred Kocher, Guenter Laufer, Irene M Lang, Julia Mascherbauer
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8c4e4b3b9103426c848f1d357e71c58d
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spelling	oai:doaj.org-article:8c4e4b3b9103426c848f1d357e71c58d2021-11-18T08:43:43ZFactors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.1932-620310.1371/journal.pone.0081940https://doaj.org/article/8c4e4b3b9103426c848f1d357e71c58d2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24312608/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>"Patient-prosthesis mismatch" (PPM) after aortic valve replacement (AVR) has been reported to increase morbidity and mortality. Although algorithms have been developed to avoid PPM, factors favouring its occurrence have not been well defined.<h4>Design and setting</h4>This was a prospective cohort study performed at the Medical University of Vienna.<h4>Patients</h4>361 consecutive patients who underwent aortic valve replacement for isolated severe aortic stenosis were enrolled.<h4>Main outcome measures</h4>Patient- as well as prosthesis-related factors determining the occurrence of moderate and severe PPM (defined as effective orifice area indexed to body surface area ≤ 0.8 cm(2)/m(2)) were studied.<h4>Results</h4>Postoperatively, 172 patients (48%) were diagnosed with PPM. The fact that predominantly female patients were affected (58% with PPM diagnosis in women versus 36% in men, p<0.001) was explained by the finding that they had smaller aortic root diameters (30.5±4.7 mm versus 35.3±4.2 mm, p<0.0001) and a higher proportion of bioprosthetic valves (82% versus 62%, p<0.0001), both independent predictors of PPM (aortic root diameter: OR 0.009 [95% CI, 0.004;0.013]; p = 0.0003, presence of bioprosthetic valve: OR 0.126 [95% CI, 0.078;0.175]; p<0.0001).<h4>Conclusions</h4>The occurrence of PPM is determined by aortic root diameter and prosthesis type. Novel sutureless bioprostheses with optimized hemodynamic performance or transcatheter aortic valves may become a promising alternative to conventional bioprosthetic valves in the future.Diana BondermanAlexandra GrafAndreas A KammerlanderAlfred KocherGuenter LauferIrene M LangJulia MascherbauerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 12, p e81940 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Diana Bonderman Alexandra Graf Andreas A Kammerlander Alfred Kocher Guenter Laufer Irene M Lang Julia Mascherbauer Factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.
description	<h4>Objective</h4>"Patient-prosthesis mismatch" (PPM) after aortic valve replacement (AVR) has been reported to increase morbidity and mortality. Although algorithms have been developed to avoid PPM, factors favouring its occurrence have not been well defined.<h4>Design and setting</h4>This was a prospective cohort study performed at the Medical University of Vienna.<h4>Patients</h4>361 consecutive patients who underwent aortic valve replacement for isolated severe aortic stenosis were enrolled.<h4>Main outcome measures</h4>Patient- as well as prosthesis-related factors determining the occurrence of moderate and severe PPM (defined as effective orifice area indexed to body surface area ≤ 0.8 cm(2)/m(2)) were studied.<h4>Results</h4>Postoperatively, 172 patients (48%) were diagnosed with PPM. The fact that predominantly female patients were affected (58% with PPM diagnosis in women versus 36% in men, p<0.001) was explained by the finding that they had smaller aortic root diameters (30.5±4.7 mm versus 35.3±4.2 mm, p<0.0001) and a higher proportion of bioprosthetic valves (82% versus 62%, p<0.0001), both independent predictors of PPM (aortic root diameter: OR 0.009 [95% CI, 0.004;0.013]; p = 0.0003, presence of bioprosthetic valve: OR 0.126 [95% CI, 0.078;0.175]; p<0.0001).<h4>Conclusions</h4>The occurrence of PPM is determined by aortic root diameter and prosthesis type. Novel sutureless bioprostheses with optimized hemodynamic performance or transcatheter aortic valves may become a promising alternative to conventional bioprosthetic valves in the future.
format	article
author	Diana Bonderman Alexandra Graf Andreas A Kammerlander Alfred Kocher Guenter Laufer Irene M Lang Julia Mascherbauer
author_facet	Diana Bonderman Alexandra Graf Andreas A Kammerlander Alfred Kocher Guenter Laufer Irene M Lang Julia Mascherbauer
author_sort	Diana Bonderman
title	Factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.
title_short	Factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.
title_full	Factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.
title_fullStr	Factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.
title_full_unstemmed	Factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.
title_sort	factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/8c4e4b3b9103426c848f1d357e71c58d
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Factors determining patient-prosthesis mismatch after aortic valve replacement--a prospective cohort study.

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