PATIENT PROSTHESIS MISMATCH IN STENTED BIOLOGIC AORTIC VALVE PROSTHESIS: 10 YEARS’ RESULTS

Authors

  • Márcio Madeira Cardiothoracic surgery, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
  • Sara Ranchordás Cardiothoracic surgery, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
  • Paulo Oliveira Cardiothoracic surgery, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
  • Tiago Nolasco Cardiothoracic surgery, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
  • Marta Marques Cardiothoracic surgery, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
  • Miguel Sousa-Uva Cardiothoracic surgery, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
  • Miguel Abecasis Cardiothoracic surgery, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
  • José Neves Cardiothoracic surgery, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal

DOI:

https://doi.org/10.48729/pjctvs.122

Abstract

Objectives: The goal of this study is to establish the relation between aortic bio prosthesis, patient prosthesis mismatch (PPM) and short-term mortality and morbidity as well as and long-term mortality.

Methods: This is a single center retrospective study with 812 patients that underwent isolated stented biologic aortic valve replacement between 2007 and 2016. The projected indexed orifice area was calculated using the in vivo previously published values. Outcomes were evaluated with the indexed effective orifice area (iEOA) as a continuous variable and/or nominal variable. Multivariable models were developed including clinically relevant co-variates.

Results: In the study population 65.9% (n=535) had no PPM, 32.6% (n=265) had moderate PPM and 1.5% (n=12) severe PPM. PPM was related with diabetes (OR:1.738, CI95:1.333-2.266; p<0.001), heart failure (OR:0.387, CI95:0.155-0.969; p=0.043) and older age (OR:1.494, CI95:1.171-1.907; p=0.001). iEOA was not an independent predictor of in-hospital mortality (OR 1.169, CI 0.039-35.441) or MACCE (OR 2.753, CI 0.287-26.453). Long term survival is significantly inferior with lower iEOA (HR 0.116, CI 0.041-0.332) and any degree of PPM decreases survival when compared with no PPM (Moderate: HR 1.542, CI 1.174-2.025; Severe HR 4.627, CI 2.083-10.276).

Conclusions: PPM appears to have no impact on short-term outcomes including mortality and morbidity. At ten years follow-up, moderate or severe PPM significantly reduces the long-term survival.

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Published

26-05-2021

How to Cite

1.
Madeira M, Ranchordás S, Oliveira P, Nolasco T, Marques M, Sousa-Uva M, Abecasis M, Neves J. PATIENT PROSTHESIS MISMATCH IN STENTED BIOLOGIC AORTIC VALVE PROSTHESIS: 10 YEARS’ RESULTS. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 May 26 [cited 2023 Feb. 3];26(2):101-7. Available from: https://pjctvs.com/index.php/journal/article/view/122

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