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Effect of Valve Prosthesis – Patient Mismatch
on Short Term Outcome after Aortic Valve Replacement
Amr Badr1, Hosam Fawzy2
Departments of Cardiology1 and Cardio-Thoracic Surgery2,
Tanta University Hospital, Tanta, Egypt.
Tanta Med. Sc. J 2007; 2(3):13-18
Article type: Original article
Background/Aim: Small- size prostheses for aortic
valve replacement can be too small in relation to the body size,
thus causing valve prosthesis-patient mismatch (PPM) and abnormally
high transvalvular pressure gradient. This study was planned to
examine the relation between the PPM and the short term outcome
after the operation. Patients and Methods: Baseline risk factors and
short term outcome were analyzed in 23 patients, 19 (82.6%) males
and 4(17.4%) females who underwent Aortic valve replacement. The
indexed valve effective orifice area (IEOA) was estimated for each
type and size of prosthesis implanted. PPM was defined as not
clinically significant if patient IEOA is > 0.85 cm2/m2 while
clinically significant if patient IEOA is ≤ 0.85 cm2/m2. Results:
Study patients were divided into 2 groups, group “A” (9 patients
with IEOA ≤0.85 cm2/m2) and group “B” (14 patients with IEOA > 0.85
cm2/m2). There was no statistical difference between both groups
regarding pre-operative patients’ demographics. Operative
characteristics were similar among patients in both groups with no
statistical significance difference. ICU stay was 2.8 + 1.5 days in
group A vs. 3.2 + 1.9 days in group B (p =0.08). While total
hospital stay was 12.5 + 9.8 days in Group A vs. 13.6 + 9.8 days in
group B (p =0.59).The early mortality was encountered in two
patients in group A and one patient in group B (p =0.59).
Conclusion: Prosthesis-Patient Mismatch has no significant effect on
short term outcome in patients undergoing Aortic Valve Replacement. |