Patient-Prosthesis Mismatch in Contemporary Small-Size Mechanical Prostheses Does Not Impact Survival at 10 Years

• Published in: Journal of cardiovascular development and disease Vol. 9; no. 2; p. 48
• Main Authors: Feier, Horea, Mocan, Mihaela, Grigorescu, Andrei, Falnita, Lucian, Gaspar, Marian, Luca, Constantin-Tudor
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 31.01.2022; MDPI
• Subjects: Aortic stenosis; aortic valve; Body mass index; Cardiovascular disease; Cerebrovascular disease; Chronic obstructive pulmonary disease; Coronary vessels; Diabetes; Ejection fraction; mechanical valve; Mortality; Patients; patient–prosthesis mismatch; propensity matching; Prostheses; Pulmonary arteries; Pulmonary hypertension; Surgery; Survival analysis; Vein & artery diseases; aortic valve; patient–prosthesis mismatch; mechanical valve; propensity matching
• ISSN: 2308-3425; 2308-3425
• DOI: 10.3390/jcdd9020048

The effect of PPM in mechanical prostheses on long-term survival is not well-established. Patients who received a 21 mm or smaller aortic valve between 2000 and 2011 were retrospectively analyzed ( = 416). Propensity matching was used in order to account for baseline differences in patient subgroups (PPM vs. no PPM; severe PPM vs. no severe PPM). Five- and ten-year survival was 78 ± 3.52% and 64.51 ± 4.51% in patients with PPM, versus 83.3 ± 3.12% and 69.37 ± 4.36% in patients without ( = 0.28) when analyzed at 10.39 ± 5.25 years after the primary procedure. Independent risk factors for impaired survival, after matching, were age, serum creatinine, and severe pulmonary hypertension. Five- and ten-year survival in patients with severe PPM was 73.34 ± 6.01% and 61.76 ± 8.17%, respectively, versus 74.72 ± 5.68% and 67.50 ± 7.09% in those without ( = 0.49), at 8.82 ± 5.17 years after SAVR. Age was the only independent variable that influenced long-term survival when severe PPM was added to the model. PPM or severe PPM does not impact long-term survival up to 10 years in mechanical valve recipients when matching for preoperative variables.