Joshi SS, Ashwini T, George A, Jagadeesh AM. Patient prosthesis mismatch after aortic valve replacement: An Indian perspective.
Ann Card Anaesth 2016;
19:84-8. [PMID:
26750679 PMCID:
PMC4900404 DOI:
10.4103/0971-9784.173025]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
CONTEXT
Perioperative period.
AIMS
Occurrence of PPM after AVR, factors associated with PPM, impact on mortality.
SETTINGS AND DESIGN
Teritary Care Referral Cardiac Centre.
MATERIALS AND METHODS
A retrospective analysis of AVR procedures at a single centre over 4 years was conducted. Demographic, echocardiographic and outcome data were collected from institute database. Rahimtoola criteria of indexed effective orifice area (iEOA) were used to stratify patients into PPM categories. Patients with and without PPM were compared for associated factors.
STATISTICAL ANALYSIS USED
Independent t-test, chi-square test, logistic regression analysis, ROC-AUC, Youden index.
RESULTS
606 patients with complete data were analysed for PPM. The incidence of mild, moderate and severe PPM was 6.1% (37), 2.5% (15) and 0.5% (3) respectively. There was no impact of PPM on all-cause in-hospital mortality. PPM was observed more with Aortic Stenosis (AS) compared to Aortic Regurgitation (AR) as etiology. Aortic annulus indexed to BSA (iAA) had a very good predictive ability for PPM at <16mm/m 2 BSA.
CONCLUSIONS
PPM has lower incidence after AVR in this Indian population and does not increase early mortality. Patients with AS and iAA<16mm/m2BSA should be cautiously dealt with to prevent PPM.
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