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General Thoracic and Cardiovascular Surgery

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Open Access 01-05-2013 | Original Article

Patient-prosthesis mismatch in patients with aortic valve replacement

Authors: Yuichiro Kaminishi, Yoshio Misawa, Junjiro Kobayashi, Hiroaki Konishi, Hiroaki Miyata, Noboru Motomura, Shin-ichi Takamoto, Japan Cardiovascular Surgery Database Organization

Published in: General Thoracic and Cardiovascular Surgery | Issue 5/2013

Abstract

Objective

Patient-prosthesis mismatch (PPM) may affect clinical outcomes in patients with aortic valve replacement (AVR). We retrospectively examined the PPM in patients with isolated AVR in the Japan Adult Cardiovascular Surgery Database (JACVSD).

Methods

We examined all patients with isolated AVR between January 1, 2008 and December 31, 2009. The JACVSD data collection form has a total of 255 variables. We defined PPM as an effective orifice area index of ≤0.85 m²/cm².

Results

PPM was observed in 306 of 3,609 cases analyzed, PPM rate was 8.5 %. Body surface area was larger and body mass index was higher in the PPM group than the non-PPM group (P < 0.001). Patients with PPM were older (P = 0.001) and had a higher prevalence of diabetes (P = 0.004), dyslipidemia (P < 0.001), hypertension (P < 0.001), cerebrovascular disease (P = 0.031), old myocardial infarction (P = 0.006), previous percutaneous coronary artery intervention (P = 0.001), coronary artery disease (P = 0.018), and aortic valve stenosis (P < 0.001). Perioperative blood transfusion (P < 0.001) and dialysis (P = 0.005) were more frequent in the PPM group. Postoperative ventilation (P = 0.004) and intensive care unit stay (P = 0.004) were significantly longer in the PPM group.

Conclusions

Age, aortic valve stenosis, dyslipidemia, hypertension, old myocardial infarction, previous percutaneous coronary artery intervention, diabetes mellitus, cerebrovascular disease, and high body mass index were the risk factors for PPM. PPM was not an independent risk factor for short-term mortality.

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Title: Patient-prosthesis mismatch in patients with aortic valve replacement
Authors: Yuichiro Kaminishi
Yoshio Misawa
Junjiro Kobayashi
Hiroaki Konishi
Hiroaki Miyata
Noboru Motomura
Shin-ichi Takamoto
Japan Cardiovascular Surgery Database Organization
Publication date: 01-05-2013
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 5/2013
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-013-0216-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Patient-prosthesis mismatch in patients with aortic valve replacement

Abstract

Objective

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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