The Early Clinical Results of Prosthesis-patient Mismatch after Aortic Replacement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUHong-hao ¹ , YAOXing-xing ¹ , LISheng-bo ¹ , JIAOZhou-yang ¹ , XUjian-wei ² , GAOKe ² ,  LIUChao ¹

1. Department of Cardiac Surgery, Zhengzhou University, Zhengzhou 450052, P. R. China;
2. Department of Ultrasound, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, P. R. China;

Corresponding?author：

LIUChao, Email: Liubeilun@sohu.com

Keywords：

Aortic valve replacement; Prosthesis-patient mismatch; Effective orifice area

DOI：

10.7507/1007-4848.20160031

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To discuss the influence of early postoperative hemodynamic, postoperative mortality and the incidence of adverse cardiovascular events with the phenomenon of prosthesis-patient mismatch. Methods We retrospectively analyzed the clinical data of 89 patients who had simple aortic valve replacement in our hospital bewteen January 2012 and January 2014. The 89 patients were divided into two groups including a match group (16 females and 48 males with average age of 58.1±10.4 years) and a mismatch group (15 females and 10 males with average age of 65.3±12.8 years). We compared early results between the two groups. Results There is a statistic difference (P < 0.05) in aortic flow velocity, mean pressure gradient, and the maximum pressure gradient between the two groups. The survival rate of the match group is significantly lower than that of the mismatch group (P < 0.05). And there is a statistical difference in adverse cardiovascular event-free incidence between the two groups (P < 0.001). Conclusion The phenomenon of prosthesis-patient mismatch can affect postoperative hemodynamic and lead to heart failure after surgery. And early mortality and the incidence of cardiovascular adverse events in patients are increased due to prosthesis-patient mismatch.

Citation： LIUHong-hao, YAOXing-xing, LISheng-bo, JIAOZhou-yang, XUjian-wei, GAOKe, LIUChao. The Early Clinical Results of Prosthesis-patient Mismatch after Aortic Replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(2): 137-141. doi: 10.7507/1007-4848.20160031 Copy

1.	Pereira JJ, Lager MS, Bashir M, et al. Survival after aortic valve replacement for severe aortic stenosis with low transvalvular gradients and severe left ventricular dysfunction. Am Coll Cardiol, 2002, 39(8): 1356-1363.
2.	Dumesnil JG, Pibarot P. Prevention of moderate prosthesis-patient mismatch: Individualization vs generalization. Rev Esp Cardiol, 2010, 63(4): 387-389.
3.	Vicchio M, Della A, De M, et al. Prosthesis-patient mismatch in the elderly:survival, ventricular mass regression, and quality of life. Ann Thorac Surg, 2008, 86(6): 1791-1797.
4.	李梁剛, 姜勝利, 高長青, 等. 老年主動脈瓣置換術的臨床療效分析. 貴陽醫學院學報, 2014, 39(3): 416-418.
5.	Brownd JM, O'Brien SM, Wu C, et al. Isolated aortic valve replacement in North America comprising 108, 687 patients in 10 years: changes in risks, valve types, and outcomes in the society of thoracic surgeons national database.Thorac Cardiovasc Surg, 2009(1): 82-90.
6.	錢希明, 鐘世鎮. 主動脈瓣不匹配對老年病人術后生活質量的影響. 南方醫科大學學報, 2009, 29(10): 2055-2063.
7.	Mohty D, Dmnesnil JG, Echahidi N, et al. Impact of prosthesis-patient mismatch on long-term survival after aortic valve replacement: influence of age, obesityand left ventrieular dysflmction. J Am Coil Cardiol, 2009, 53(2): 39-47.
8.	武忠, 王東進, 李捷, 等. 主動脈瓣置換術后人工心臟瓣膜-病人不匹配現象. 中華胸心血管外科雜志, 2010, 26(6): 374-376.
9.	Moon MR, Pasque MK, Munfakh NA, et al. Prosthesis-patient mismatch after aortic valve replacement: Impact on age and body size on late survival. Ann Thorac Surg, 2006, 81(2): 481-489.
10.	Pibarot P, Dumesnil JG.Prosthesis-patient mismatch: definition, clinical impact, and prevention.Heart, 2006, 92(8):1022-1029.
11.	解少強, 吳遠林, 袁昕.主動脈瓣置換術患者人工瓣膜不匹配的影響因素分析. 臨床合理用藥, 2012, 5(5B): 30-31.
12.	Tasca G, Mhagna Z, Perotti S, et al. Impact of patient-prosthesis mismatch on cardiac events and midterm mortality after aortic valve replacement in patients with pure aortic stenosis. Circulation, 2006, 113(4): 570-576.
13.	張寶仁, 韓慶奇. 主動脈瓣置換術病人與人工瓣膜不匹配的影響與預防. 中華胸心血管外科雜志, 2010, 26(6):377-379.
14.	Pibarot P, Dumesnil JG, Lemieux M, et al.Impact of prosthesis-patient mismatch on hemodynamic and symptomatic status, morbi-dity and mortality after aortic valve replacement with a biopros-thetic heart valve. J Heart Valve Dis, 1998, 7(2): 211-218.
15.	Jessica A, Ditchfield MD, Granger E, et al. Aortic valve replacement in octogenarians. Heart, Lung and Circulation, 2014, 23(9): 841-846.
16.	舒禮良, 張競超, 蘇剛, 等. 主動脈瓣置換同期部分室間隔切除治療重度主動脈瓣狹窄. 實用醫學雜志, 2013, 29(21): 3621-3622.
17.	Moro E, D'Angelo G, Nicolosi G L, et al. Long-term evaluation of patients with apical hypertrophic cardiomyopathy. Correlation between quantitative echocardiographic assessment of apical hyper-trophy and clinical-electrocardio-graphic findings. Eur Heart J, 1995, 16(2): 210-217.
18.	Benedetto U, Melina G, Refice S, et al. Dual renin-angiotensin system blockade for patients with prosthesis-patient mismatch. Ann Thorac Surg, 2010, 90(6): 1899-1903.
19.	段宇龍, 徐敬, 蘇剛, 等. β-受體阻滯劑對主動脈瓣置換術后心室內壓力階差的影響. 中國胸心血管外科臨床雜志, 2011, 18(1): 35-39.
20.	刁明強, 董力, 江虹, 等. 心臟機械瓣置換術后早期抗凝的方法分析. 中國胸心血管外科臨床雜志, 2006, 13(1): 10-13.

1. Pereira JJ, Lager MS, Bashir M, et al. Survival after aortic valve replacement for severe aortic stenosis with low transvalvular gradients and severe left ventricular dysfunction. Am Coll Cardiol, 2002, 39(8): 1356-1363.
2. Dumesnil JG, Pibarot P. Prevention of moderate prosthesis-patient mismatch: Individualization vs generalization. Rev Esp Cardiol, 2010, 63(4): 387-389.
3. Vicchio M, Della A, De M, et al. Prosthesis-patient mismatch in the elderly:survival, ventricular mass regression, and quality of life. Ann Thorac Surg, 2008, 86(6): 1791-1797.
4. 李梁剛, 姜勝利, 高長青, 等. 老年主動脈瓣置換術的臨床療效分析. 貴陽醫學院學報, 2014, 39(3): 416-418.
5. Brownd JM, O'Brien SM, Wu C, et al. Isolated aortic valve replacement in North America comprising 108, 687 patients in 10 years: changes in risks, valve types, and outcomes in the society of thoracic surgeons national database.Thorac Cardiovasc Surg, 2009(1): 82-90.
6. 錢希明, 鐘世鎮. 主動脈瓣不匹配對老年病人術后生活質量的影響. 南方醫科大學學報, 2009, 29(10): 2055-2063.
7. Mohty D, Dmnesnil JG, Echahidi N, et al. Impact of prosthesis-patient mismatch on long-term survival after aortic valve replacement: influence of age, obesityand left ventrieular dysflmction. J Am Coil Cardiol, 2009, 53(2): 39-47.
8. 武忠, 王東進, 李捷, 等. 主動脈瓣置換術后人工心臟瓣膜-病人不匹配現象. 中華胸心血管外科雜志, 2010, 26(6): 374-376.
9. Moon MR, Pasque MK, Munfakh NA, et al. Prosthesis-patient mismatch after aortic valve replacement: Impact on age and body size on late survival. Ann Thorac Surg, 2006, 81(2): 481-489.
10. Pibarot P, Dumesnil JG.Prosthesis-patient mismatch: definition, clinical impact, and prevention.Heart, 2006, 92(8):1022-1029.
11. 解少強, 吳遠林, 袁昕.主動脈瓣置換術患者人工瓣膜不匹配的影響因素分析. 臨床合理用藥, 2012, 5(5B): 30-31.
12. Tasca G, Mhagna Z, Perotti S, et al. Impact of patient-prosthesis mismatch on cardiac events and midterm mortality after aortic valve replacement in patients with pure aortic stenosis. Circulation, 2006, 113(4): 570-576.
13. 張寶仁, 韓慶奇. 主動脈瓣置換術病人與人工瓣膜不匹配的影響與預防. 中華胸心血管外科雜志, 2010, 26(6):377-379.
14. Pibarot P, Dumesnil JG, Lemieux M, et al.Impact of prosthesis-patient mismatch on hemodynamic and symptomatic status, morbi-dity and mortality after aortic valve replacement with a biopros-thetic heart valve. J Heart Valve Dis, 1998, 7(2): 211-218.
15. Jessica A, Ditchfield MD, Granger E, et al. Aortic valve replacement in octogenarians. Heart, Lung and Circulation, 2014, 23(9): 841-846.
16. 舒禮良, 張競超, 蘇剛, 等. 主動脈瓣置換同期部分室間隔切除治療重度主動脈瓣狹窄. 實用醫學雜志, 2013, 29(21): 3621-3622.
17. Moro E, D'Angelo G, Nicolosi G L, et al. Long-term evaluation of patients with apical hypertrophic cardiomyopathy. Correlation between quantitative echocardiographic assessment of apical hyper-trophy and clinical-electrocardio-graphic findings. Eur Heart J, 1995, 16(2): 210-217.
18. Benedetto U, Melina G, Refice S, et al. Dual renin-angiotensin system blockade for patients with prosthesis-patient mismatch. Ann Thorac Surg, 2010, 90(6): 1899-1903.
19. 段宇龍, 徐敬, 蘇剛, 等. β-受體阻滯劑對主動脈瓣置換術后心室內壓力階差的影響. 中國胸心血管外科臨床雜志, 2011, 18(1): 35-39.
20. 刁明強, 董力, 江虹, 等. 心臟機械瓣置換術后早期抗凝的方法分析. 中國胸心血管外科臨床雜志, 2006, 13(1): 10-13.

Previous Article
肝血管瘤與精準外科治療
Next Article
肝血管瘤與精準外科治療

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The Early Clinical Results of Prosthesis-patient Mismatch after Aortic Replacement

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content