Sato Manabu, Suenaga Etsuro, Koga Shugo, Kawasaki Hiromitsu
Nagasaki Kouseikai Hospital, Japan.
Asian Cardiovasc Thorac Ann. 2011 Oct;19(5):314-9. doi: 10.1177/0218492311419449.
The occurrence of prosthesis-patient mismatch after aortic valve replacement with a small valve size was evaluated in 249 patients, focusing on echocardiographic data. Aortic valve pathology included regurgitation in 174 patients and stenosis in 75. Echocardiography was performed in the early and late postoperative periods. A projected effective orifice area index < 0.85 cm(2)·m(-2) was noted in 56 patients; values ≥ 0.85 cm(2)·m(-2) were found in 128. Postoperative changes in ejection fraction, left ventricular mass regression, and peak transprosthetic gradient were similar in both groups. Small prostheses (≤ 19 mm) were used in 43 patients who had significantly higher postoperative transprosthetic gradients in both the early and late periods, compared to those with larger prostheses. Our findings show that the occurrence of prosthesis-patient mismatch after aortic valve replacement is rare. Left ventricular mass regression occurred in most patients, with acceptable transprosthetic gradients.
在249例患者中评估了使用小尺寸瓣膜进行主动脉瓣置换术后人工瓣膜-患者不匹配的发生情况，重点关注超声心动图数据。主动脉瓣病变包括174例反流患者和75例狭窄患者。在术后早期和晚期均进行了超声心动图检查。56例患者的预计有效瓣口面积指数<0.85 cm²·m⁻²；128例患者的值≥0.85 cm²·m⁻²。两组患者的射血分数、左心室质量消退和经人工瓣膜峰值梯度的术后变化相似。43例患者使用了小尺寸人工瓣膜（≤19 mm），与使用较大尺寸人工瓣膜的患者相比，这些患者在术后早期和晚期的经人工瓣膜梯度均显著更高。我们的研究结果表明，主动脉瓣置换术后人工瓣膜-患者不匹配的发生率很低。大多数患者出现了左心室质量消退，经人工瓣膜梯度可接受。
