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      Absence of prosthesis-patient mismatch with the new generation of Edwards stented aortic bioprosthesis.

      Interactive cardiovascular and thoracic surgery
      Aged, Aged, 80 and over, Animals, Aortic Valve, physiopathology, surgery, ultrasonography, Aortic Valve Stenosis, mortality, Bioprosthesis, Echocardiography, Doppler, Female, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, adverse effects, instrumentation, Hemodynamics, Hospital Mortality, Humans, Male, Middle Aged, Patient Selection, Prosthesis Design, Stents, Swine, Time Factors, Treatment Outcome

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          Abstract

          Prosthesis-patient mismatch (PPM) remains a controversial issue with the most recent stented biological valves. We analyzed the incidence of PPM after implantation of the Carpentier-Edwards Perimount Magna Ease aortic valve (PMEAV) bioprosthesis and assessed the early clinical outcome. Two hundred and seventy consecutive patients who received a PMEAV bioprosthesis between January 2007 and July 2008 were analyzed. Pre-, peri- and postoperative data were assessed and echocardiographic as well as clinical follow-up was performed. Mean age was 72+/-9 years, 168 (62.2%) were males. Fifty-seven patients (21.1%) were below 65 years of age. Absence of PPM, corresponding to an indexed effective orifice area >0.85 cm(2)/m(2), was 99.5%. Observed in-hospital mortality was 2.2% (six patients), with a predicted mortality according to the additive EuroSCORE of 7.6+/-3.1%. At echocardiographic assessment after a mean follow-up period of 150+/-91 days, mean transvalvular gradient was 11.8+/-4.8 mmHg (all valve sizes). No paravalvular leakage was seen. Nine patients died during follow-up. The Carpentier-Edwards PMEAV bioprosthesis shows excellent hemodynamic performance. This valve can be implanted in all sizes with an incidence of severe PPM below 0.5%.

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