Impact of patient-prosthesis mismatch following aortic valve replacement on short-term survival: a retrospective single center analysis of 632 consecutive patients with isolated stented biological aortic valve replacement.

OBJECTIVES

The impact of patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) on short-term and long-term mortality remains controversial. The objective of this study was to evaluate the incidence and severity of PPM and its impact on short-term survival in a large cohort of patients treated with isolated stented biological AVR in a single institution.

METHODS

We analyzed retrospectively data of 632 consecutive patients with aortic stenosis undergoing isolated stented biological AVR between January 2007 and February 2012 at our institution. PPM was defined as an indexed effective orifice area ≤ 0.85 cm(2)/m(2). Statistical analyses were performed to identify influencing variables on valve size implanted.

RESULTS

Of the 632 patients investigated, 46% were females and mean age was 71.9 ± 10.4 years. PPM was observed in 93.8% (593 of 632 patients). In 71% of the patients, moderate (0.65-0.85 cm(2)/m(2)) PPM was present and in 22.8% severe (< 0.65 cm(2)/m(2)) PPM was present. The 30-day mortality was 1.4% (9 of 632 patients) with all being females. PPM was not associated with increased 30-day mortality. Multiple regression analyses demonstrated the usefulness of sex, height, body mass index, and body surface area as simultaneous predictors of the valve size implanted (R(2)= 0.39).

CONCLUSION

PPM had no discernable impact on short-term survival, although it was present in 93.8% of our patients following isolated stented biological AVR.