Department of Cardiac Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
Chin Med J (Engl). 2013;126(19):3762-6.
To determine whether the prosthesis-patient mismatch has a deleterious impact on survival after mitral valve replacement.
A comprehensive literature search of PubMed, Embase, and ScienceDirect was carried out. References and cited papers of relevant articles were also checked.
All articles published after January 1980 was initially considered. Non-English and non-human studies, case reports, and reviews were excluded from the initial search. References and cited papers of relevant articles were also checked.
A total of 8 retrospective cohort studies were identified for this review. The overall incidence of prosthesis-patient mismatch (<1.3 to <1.2 cm(2)/m(2)) after mitral valve replacement ranged from 3.7% to 85.9% (moderate prosthesis-patient mismatch (0.9 to 1.2 cm(2)/m(2)) in 37.4% to 69.5%, severe prosthesis-patient mismatch (<0.9 cm(2)/m(2)) in 8.7% to 16.4%). Four studies demonstrated an association of prosthesis-patient mismatch with reduced long-term survival, but the other four studies found no significant deleterious impact of prosthesis-patient mismatch after mitral valve replacement. No definite conclusion could be derived from these conflicting results.
Current evidence is insufficient to derive a definite conclusion whether mitral prosthesis-patient mismatch affects long-term survival because of the biases and confounding factors that interfere with late clinical outcomes. Goodquality prospective studies are warranted to evaluate the impact of mitral prosthesis-patient mismatch after mitral valve replacement in the future.
确定二尖瓣置换术后人工瓣膜-患者不匹配是否对生存产生有害影响。
对 PubMed、Embase 和 ScienceDirect 进行了全面的文献检索。还检查了相关文章的参考文献和引用文献。
最初考虑了 1980 年 1 月以后发表的所有文章。从初步搜索中排除了非英语和非人类研究、病例报告和综述。还检查了相关文章的参考文献和引用文献。
本综述共确定了 8 项回顾性队列研究。二尖瓣置换术后人工瓣膜-患者不匹配（<1.3 至<1.2cm²/m²）的总发生率为 3.7%至 85.9%（中度人工瓣膜-患者不匹配（0.9 至 1.2cm²/m²）占 37.4%至 69.5%，严重人工瓣膜-患者不匹配（<0.9cm²/m²）占 8.7%至 16.4%）。四项研究表明人工瓣膜-患者不匹配与长期生存降低相关，但另外四项研究发现二尖瓣置换术后人工瓣膜-患者不匹配没有显著的有害影响。这些相互矛盾的结果无法得出明确的结论。
由于干扰晚期临床结果的偏倚和混杂因素，目前的证据不足以得出人工瓣膜-患者不匹配是否影响二尖瓣置换术后长期生存的明确结论。需要进行高质量的前瞻性研究，以评估未来二尖瓣置换术后人工瓣膜-患者不匹配对二尖瓣的影响。
