Clinical Impact of Patient-Prosthesis Mismatch After Aortic Valve Replacement With a Mechanical or Biological Prosthesis

Overview

Journal Tex Heart Inst J

Specialty Cardiology & Vascular Diseases

Date 2023 Oct 23

PMID 37867308

Authors

Milos Matkovic

Nemanja Aleksic

Ilija Bilbija

Ana Antic

Jelena Milin Lazovic

Marko Cubrilo

Aleksandar Milojevic

Igor Zivkovic

Svetozar Putnik

Affiliations

Soon will be listed here.

Abstract

Background: Patient-prosthesis mismatch (PPM) may impair functional capacity and survival after aortic valve replacement. This study aimed to investigate the impact of PPM on long-term survival and quality of life after mechanical and biological aortic valve replacement.

Methods: This study included 595 consecutive patients who had undergone isolated aortic valve replacement. Patients were divided into 2 groups according to prosthesis type. The baseline and operative characteristics, survival rates, complications, and quality of life of the groups with and without PPM were compared for up to 6 years. The PPM calculation was performed using the effective orifice area value provided by the manufacturer divided by the patient's body surface area.

Results: The moderate to severe PPM rates were 69.8% and 3.7% after biological and mechanical prosthesis implantation, respectively. Mean survival for patients in the biological group who had PPM was statistically significantly shorter (50.2 months [95% CI, 45.2-55.3]) than for patients in the biological group without PPM (60.1 months [95% CI, 55.7-64.4]; P = .04). In the mechanical prosthesis group, there was no difference in mean survival between the subgroup with PPM (66.6 months [95% CI, 58.3-74.9]) and the subgroup without PPM (64.9 months [95% CI, 62.6-67.2]; P = .50). A quality-of-life questionnaire's scores did not differ between the groups.

Conclusion: Mismatch is common after biological valve implantation and statistically significantly affects long-term survival and quality of life. If the risk of PPM after implantation of a biological prosthesis is suspected, adopting strategies to avoid PPM at the time of surgery is warranted.

Citing Articles

Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates.

Toporcer T, Lukacin S, Kraus A, Homola M, Beres A, Trebisovsky M J Cardiovasc Dev Dis. 2025; 12(2).

PMID: 39997478 PMC: 11856024. DOI: 10.3390/jcdd12020044.

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