Hemodynamically significant prosthesis-patient mismatch can be predicted and is associated with early prosthetic valve dysfunction in aortic bioprosthesis
| Autor: | Fernando Piccinini, María de la Paz Ricapito, María F. Castro, María Teresa Politi, Juan Mariano Vrancic, Franklin Cueva Torres, Paola Kuschnir, Ricardo Ronderos, Agustina Sciancalepore, Daniel Navia, Mariano Camporrotondo, Mariana Cecilia Mahia |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Hemodynamics Pannus 030204 cardiovascular system & hematology Doppler echocardiography Prosthesis Design Prosthesis 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Risk Factors Internal medicine medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Retrospective Studies Bioprosthesis Heart Valve Prosthesis Implantation medicine.diagnostic_test business.industry Retrospective cohort study Aortic Valve Stenosis medicine.disease Thrombosis Cardiac surgery Treatment Outcome Aortic Valve Heart Valve Prosthesis Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Echocardiography (Mount Kisco, N.Y.)REFERENCES. 38(6) |
| ISSN: | 1540-8175 |
| Popis: | OBJECTIVES To evaluate the accuracy of predicted prosthesis-patient mismatch (PPM) regarding actual PPM measured postoperatively. To assess the association between PPM and prosthetic valve dysfunction. METHODS Retrospective cohort study including adult patients after aortic valve replacement surgery with a biological prosthesis. Predicted PPM status was determined using mean reference effective orifice area indexed to total body surface (iEOA), without considering reference standard deviations. Postoperative PPM status was determined by measuring iEOA within the first 60 postoperative days. Prosthetic valve dysfunction was defined as thrombosis, pannus, valve degeneration, and/or disruption. RESULTS 205 patients were enrolled between January 2003 and June 2017: predicted PPM was absent in 52 patients (25.4%), moderate in 137 patients (66.8%), and severe in 16 patients (7.8%). After surgery, the actual postoperative iEOA was measured: 53 (25.9%) did not have PPM, 73 had moderate PPM (35.6%), and 79 had severe PPM (38.5%). Predicted PPM identified the presence of hemodynamically significant actual postoperative PPM (OR = 2.56; 95%CI 1.30-5.05; P = .006), though not its degree of severity. Prosthetic valve dysfunction was more frequent among patients with hemodynamically significant PPM (53.9% vs. 11.3%; P |
| Databáze: | OpenAIRE |
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