Effect of prosthesis-patient mismatch after aortic valve replacement with mechanical valve on operative mortality
10.3724/SP.J.1008.2013.00403
- Author:
Lü WANG
1
Author Information
1. Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University
- Publication Type:Journal Article
- Keywords:
Aortic valve;
Heart valve prosthesis;
Hospital mortality;
Risk adjustment;
Stenosis
- From:
Academic Journal of Second Military Medical University
2013;34(4):403-406
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the relationship between early mortality and degree of prosthesis-patient mismatch (PPM) after aortic valve replacement surgery using risk-adjusted mortality of EuroSCORE II Methods The clinical data of 1 247 consecutive patients who underwent aortic valve replacement from Jan. 1, 2007 to Dec. 31, 2011 in our hospital were retrospectively analyzed. The EuroSCORE II -predicted mortality and the effective orifice area index (EOAi) of artificial aortic valve were calculated for each patient. The patients were divided into three groups according to aortic EOAi: non-to-mild PPM, moderate PPM, and severe PPM Risk-adjusted mortality and 95% confidence interval were calculated for each group. The EuroSCORE II-predicted mortality and risk-adjusted mortality were compared among three groups. Results The observed mortality was 2. 79% (29/1 040) for patients with non-to-mild PPM, 5. 00% (8/160) for patients with moderate PPM, and 8 51% (4/47) for patients with severe PPM, with significant differences found between groups (P<0. 05). There were no significant differences in EuroSCORE II-predicted mortalities among the three groups (2. 82% for the non-to-mild PPM group, 2. 69% for the moderate PPM group, and 2. 72% for the severe PPM group). And the risk-adjusted mortality of non-to-mild PPM group (0. 99, 95%CI: 0. 93-1. 05) was significantly lower than those of moderate PPM group (1. 86, 95%CI: 1. 68-2. 08) and severe PPM group (3. 13, 95%CI: 2. 56-4. 00). Conclusion High degree of aortic PPM after aortic valve replacement is associated with increased operative mortality.
