Yottasurodom Chaiwut, Namthaisong Kriengkrai, Porapakkham Pramote, Kasemsarn Choosak, Chotivatanapong Taweesak, Chaiseri Pradistchai, Wongdit Suwannee, Yasotarin Suwanna
Department of Cardiothoracic Surgery, Central Chest Institue of Thailand, Nonthaburi, Thailand.
J Med Assoc Thai. 2012 Aug;95 Suppl 8:S64-70.
To analyze the relationship between prosthetic aortic valve orifice and body surface area (Effective Orifice Area Index, EOAI) and in-hospital mortality after aortic valve replacement.
A prospective study was conducted between October 2007 to September 2010, 536 patients underwent isolated aortic valve replacement (AVR) was recorded on preoperative, operative and postoperative data. Patient Prosthesis Mismatch (PPM) was classified by Effective Orifice Area Indexed (EOAI) by prosthetic valve area divided by body surface area as mild or no significance if the EOAI is greater than 0.85 cm2/m2, moderate if between 0.65 cm2/m2 and 0.85 cm2/m2, and severe if less than 0.65 cm2/m2. Statistical differences were analyzed by Chi-square and student t-test with p-value less than 0.05 considered significant.
There were 304 men, mean age was 60.98 years, mean valve orifice area 1.69 cm2, body surface area 1.60 m2, cross clamp time 1.13 hrs., bypass time 1.67 hrs. Mechanical valves were used in 274 patients (51.2%) and Bioprosthesis were used in 181 patients (48.8%). PPM was found in 33.7%, 6.7% was severe PPM, 27% was moderate PPM and 66.3% has no significant PPM Over all in-hospital mortality was 1.5%. There was no significant difference in hospital mortality between no PPM group, moderate PPM and severe PPM group (1.4% vs. 1.4% vs. 5.4%, p-value = 0.86).
In a large aortic valve surgery population, moderate and severe patient prosthesis mismatch occurred in 35.6% of patients but had no influence on in-hospital mortality.
分析人工主动脉瓣口面积与体表面积的关系（有效瓣口面积指数，EOAI）以及主动脉瓣置换术后的院内死亡率。
于2007年10月至2010年9月进行一项前瞻性研究，记录了536例行单纯主动脉瓣置换术（AVR）患者的术前、术中及术后数据。患者-人工瓣膜不匹配（PPM）根据有效瓣口面积指数（EOAI）进行分类，即人工瓣膜面积除以体表面积，若EOAI大于0.85 cm²/m²则为轻度或无显著意义，若在0.65 cm²/m²至0.85 cm²/m²之间则为中度，若小于0.65 cm²/m²则为重度。采用卡方检验和学生t检验分析统计学差异，p值小于0.05认为具有显著性。
有304名男性，平均年龄为60.98岁，平均瓣口面积1.69 cm²，体表面积1.60 m²，阻断时间1.13小时，体外循环时间1.67小时。274例患者（51.2%）使用机械瓣膜，181例患者（48.8%）使用生物瓣膜。发现PPM的比例为33.7%，其中重度PPM为6.7%，中度PPM为27%，无显著PPM的比例为66.3%。总体院内死亡率为1.5%。无PPM组、中度PPM组和重度PPM组之间的院内死亡率无显著差异（1.4%对1.4%对5.4%，p值 = 0.86）。
在一大群主动脉瓣手术患者中，35.6%的患者发生了中度和重度患者-人工瓣膜不匹配，但对院内死亡率无影响。
