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      Incidence and Impact of Patient-Prosthesis Mismatch in Isolated Aortic Valve Surgery

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          Abstract

          AIM:

          The mains topics of this work are the incidence of patient-prosthesis mismatch and the influence in the early results of isolated aortic valve surgery.

          METHODS:

          In 193 patients isolated aortic valve surgery was performed. The study population was divided in three subgroups: 20 patients with severe, 131 patients with moderate and 42 patients without patient-prosthesis mismatch. The indexed effective orifice area was used to define the subgroups. Operative mortality and perioperative complications were considered the indicators of the early results of aortic valve surgery.

          RESULTS:

          The incidence of severe and moderate patient-prosthesis mismatch was respectively 10.3% and 67.8%. Hospital mortality and perioperative complications were: mortality 5% vs. 3.1% vs. 2.4% (p = 0.855), low cardiac output 5% vs. 6.9% vs. 4.8% (p = 0.861); pulmonary complications 5% vs. 3.1 vs. 0.0% (p = 0.430); exploration for bleeding 5% vs. 0.8% vs. 2.4% (p = 0.319); atrial fibrillation 30% vs. 19.8% vs. 11.9% (p = 0.225); wound infection 5% vs. 0.8% vs. 0.00% (p = 0.165), respectively for the group with severe, moderate and without patient-prosthesis mismatch.

          CONCLUSIONS:

          Patient-prosthesis mismatch is a common occurrence in aortic valve surgery. This phenomenon does not affect the early results of aortic valve surgery.

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          Most cited references19

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          Prosthetic heart valves: selection of the optimal prosthesis and long-term management.

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            ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons.

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              The problem of valve prosthesis-patient mismatch.

              Valve prostheses have played an important part in the past two decades in the management of patients with valvular heart disease. However, many of the devices used in valve replacement have introduced new clinical problems. This paper deals with some of the problems associated with valve replacement, including one not previously emphasized--valve prosthesis-patient mismatch, which may cause obstruction to ventricular outflow and/or inflow.

                Author and article information

                Journal
                Open Access Maced J Med Sci
                Open Access Maced J Med Sci
                OA Maced J Med Sci
                Open Access Macedonian Journal of Medical Sciences
                Institute of Immunobiology and Human Genetics (Republic of Macedonia )
                1857-9655
                15 December 2015
                15 October 2015
                : 3
                : 4
                : 624-629
                Affiliations
                [1 ] Service of Cardiac Surgery, University Hospital Center “Mother Theresa”, Tirana, Albania
                [2 ] Service of Statistics, University Hospital Center “Mother Theresa”, Tirana, Albania
                [3 ] Obstetrics and Gynecology Hospital “Queen Geraldine”, Tirana, Albania
                Author notes
                [* ] Correspondence: Selman Dumani, MD, PhD. UHC “Mother Theresa”, Service of Cardiac Surgery, Dibra Street 372, Tirana, Albania. E-mail: selmandumani@ 123456yahoo.co.uk
                Article
                OAMJMS-3-624
                10.3889/oamjms.2015.108
                4877898
                27275298
                36f5bc45-ac7b-4b17-a8c9-1db9624007d2
                Copyright: © 2015 Selman Dumani, Ermal Likaj, Andi Kacani, Laureta Dibra, Elizana Petrela, Vera Beca, Ali Refatllari.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 30 June 2015
                : 05 October 2015
                : 06 October 2015
                Categories
                Clinical Science

                aortic valve,patient-prosthesis mismatch,valve prosthesis

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