Surgical aortic valve replacement and patient-prosthesis mismatch: a meta-analysis of 108 182 patients.

Autor:	Sá MPBO; Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.; University of Pernambuco-UPE, Recife, Brazil.; Nucleus of Postgraduate and Research in Health Sciences of Faculty of Medical Sciences and Biological Sciences Institute-FCM/ICB, Recife, Brazil., de Carvalho MMB; University of Pernambuco-UPE, Recife, Brazil.; Nucleus of Postgraduate and Research in Health Sciences of Faculty of Medical Sciences and Biological Sciences Institute-FCM/ICB, Recife, Brazil., Sobral Filho DC; University of Pernambuco-UPE, Recife, Brazil.; Nucleus of Postgraduate and Research in Health Sciences of Faculty of Medical Sciences and Biological Sciences Institute-FCM/ICB, Recife, Brazil., Cavalcanti LRP; Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.; University of Pernambuco-UPE, Recife, Brazil., Rayol SDC; Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.; University of Pernambuco-UPE, Recife, Brazil., Diniz RGS; Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.; University of Pernambuco-UPE, Recife, Brazil., Menezes AM; Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.; University of Pernambuco-UPE, Recife, Brazil., Clavel MA; Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Canada., Pibarot P; Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Canada., Lima RC; Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.; University of Pernambuco-UPE, Recife, Brazil.; Nucleus of Postgraduate and Research in Health Sciences of Faculty of Medical Sciences and Biological Sciences Institute-FCM/ICB, Recife, Brazil.
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2019 Jul 01; Vol. 56 (1), pp. 44-54.
DOI:	10.1093/ejcts/ezy466
Abstrakt:	Objectives: This study sought to evaluate the impact of patient-prosthesis mismatch (PPM) on the risk of perioperative, early-, mid- and long-term mortality rates after surgical aortic valve replacement. Methods: Databases were searched for studies published until March 2018. The main outcomes of interest were perioperative mortality, 1-year mortality, 5-year mortality and 10-year mortality. Results: The search yielded 3761 studies for inclusion. Of these, 70 articles were analysed, and their data were extracted. The total number of patients included was 108 182 who underwent surgical aortic valve replacement. The incidence of PPM after surgical aortic valve replacement was 53.7% (58 116 with PPM and 50 066 without PPM). Perioperative mortality [odds ratio (OR) 1.491, 95% confidence interval (CI) 1.302-1.707; P < 0.001], 1-year mortality (OR 1.465, 95% CI 1.277-1.681; P < 0.001), 5-year mortality (OR 1.358, 95% CI 1.218-1.515; P < 0.001) and 10-year mortality (OR 1.534, 95% CI 1.290-1.825; P < 0.001) were increased in patients with PPM. Both severe PPM and moderate PPM were associated with increased risk of perioperative mortality, 1-year mortality, 5-year mortality and 10-year mortality when analysed together and separately, although we observed a higher risk in the group with severe PPM. Conclusions: Moderate/severe PPM increases perioperative, early-, mid- and long-term mortality rates proportionally to its severity. The findings of this study support the implementation of surgical strategies to prevent PPM in order to decrease mortality rates. (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
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