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patient-prosthesis mismatch

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https://www.readbyqxmd.com/read/28545592/impact-of-prosthesis-patient-mismatch-on-short-term-outcomes-after-aortic-valve-replacement-a-retrospective-analysis-in-east-china
#1
Lei Guo, Junnan Zheng, Liangwei Chen, Renyuan Li, Liang Ma, Yiming Ni, Haige Zhao
BACKGROUND: Prosthesis-patient mismatch (PPM) may affect the clinical outcomes of patients undergoing aortic valve replacement (AVR). We aimed to determine the incidence of PPM, its effect on short-term mortality, and the factors contributing to PPM in China. METHODS: We retrospectively examined all consecutive patients with isolated or concomitant AVR at our hospital between January 1, 2013 and December 31, 2015. PPM was defined as an effective orifice area index (EOAi) of ≤ 0...
May 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28540078/use-of-multidetector-row-computed-tomography-scan-to-detect-pannus-formation-in-prosthetic-mechanical-aortic-valves
#2
REVIEW
Mohamed A Aladmawi, Claudio Pragliola, Olga Vriz, Domenico Galzerano
Obstruction of a mechanical aortic valve by pannus formation at the subvalvular level is a major long-term complication of aortic valve replacement (AVR). In fact, pannus is sometime difficult to differentiate from patient-prosthesis mismatch or valve thrombosis. In most cases cine-angiography and echocardiography, either transthoracic or transesophageal, cannot correctly visualize the complication when the leaflets show a normal mobility. Recent technological refinements made this difficult diagnosis possible by ECG-gated computed tomography (CT) scan which shows adequate images in 90% of the cases and can differentiate pannus from fresh and organized thrombus...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28536830/transcatheter-aortic-valve-implantation-in-patients-on-corticosteroid-therapy
#3
Ryosuke Higuchi, Tetsuya Tobaru, Kenichi Hagiya, Mike Saji, Keitaro Mahara, Itaru Takamisawa, Jun Shimizu, Shuichiro Takanashi, Morimasa Takayama
Transcatheter aortic valve implantation (TAVI) is recommended for patients who are inoperable or at high risk for surgical aortic valve replacement (SAVR). Corticosteroid therapy is considered to be a risk factor for SAVR, but there is a paucity of information about TAVI in patients taking corticosteroids. The aim of this study is to elucidate the outcome of TAVI in patients on chronic corticosteroid therapy, compared with SAVR. We retrospectively analyzed patients on corticosteroid therapy who underwent TAVI (n = 21) or SAVR (n = 30) for severe aortic stenosis in Sakakibara Heart Institute...
May 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28521921/1-year-results-in-patients-undergoing-transcatheter-aortic-valve-replacement-with-failed-surgical-bioprostheses
#4
G Michael Deeb, Stanley J Chetcuti, Michael J Reardon, Himanshu J Patel, P Michael Grossman, Theodore Schreiber, John K Forrest, Tanvir K Bajwa, Daniel P O'Hair, George Petrossian, Newell Robinson, Stanley Katz, Alan Hartman, Harold L Dauerman, Joseph Schmoker, Kamal Khabbaz, Daniel R Watson, Steven J Yakubov, Jae K Oh, Shuzhen Li, Neal S Kleiman, David H Adams, Jeffrey J Popma
OBJECTIVES: This study evaluated the safety and effectiveness of self-expanding transcatheter aortic valve replacement (TAVR) in patients with surgical valve failure (SVF). BACKGROUND: Self-expanding TAVR is superior to medical therapy for patients with severe native aortic valve stenosis at increased surgical risk. METHODS: The CoreValve U.S. Expanded Use Study was a prospective, nonrandomized study that enrolled 233 patients with symptomatic SVF who were deemed unsuitable for reoperation...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28465144/real-structural-valve-deterioration-of-the-mitroflow-aortic-prosthesis-competing-risk-analysis
#5
Rocío Díaz, Daniel Hernández-Vaquero, Jacobo Silva, Isaac Pascual, Jesús M de la Hera, Víctor León, María Martín, Vicente Barriales, Santiago Colunga, Raquel Del Valle, César Morís
INTRODUCTION AND OBJECTIVES: The Mitroflow aortic prosthesis is a bovine pericardial bioprosthesis specially designed to increase the valve area in relation to its size. There is controversy regarding the pattern of structural valve deterioration (SVD). Our aim was to determine the cumulative incidence of SVD, risk factors influencing its occurrence, and its impact on mortality. METHODS: A total of 1028 patients were clinically and echocardiographically followed up...
April 29, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28430883/ten-year-results-of-aortic-valve-replacement-with-first-generation-mitroflow-bioprosthesis-is-early-degeneration-a-structural-or-a-technical-issue
#6
Liesbeth Lootens, Jonas Verbeke, Thomas Martens, Tine Philipsen, Frank Caes, Yves Van Belleghem, Guido Van Nooten, Katrien François, Dirk De Bacquer, Thierry Bove
OBJECTIVES: Concerns have been raised about the durability of the first-generation Mitroflow aortic bioprosthesis (model 12 A-LX) due to the lack of anticalcification treatment. This study reflects a 10-year experience with this prosthesis for aortic valve replacement. METHODS: From June 2003 to May 2012, the Mitroflow prosthesis was used for aortic valve replacement in 510 patients, of whom only 467 with complete clinical follow-up were included for analysis. Study end-points were survival and incidence of structural valve degeneration (SVD)...
April 19, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28393786/prosthesis-patient-mismatch-what-cardiac-anesthesiologists-need-to-know
#7
REVIEW
Kathirvel Subramaniam, Soheyla Nazarnia
Prosthesis-patient Mismatch (PPM) is not uncommon with an incidence reported up to 70% after aortic valve (AV) replacement. Severe forms of PPM are less common (up to 20%); PPM can lead to increased short- and long-term morbidity and mortality. It is important to discriminate PPM from other forms of prosthetic valve dysfunction. Sometimes, prosthetic valve degenerative disease may coexist with PPM. Echocardiography plays an important role in the prevention and diagnosis of PPM. Preemptive strategies to prevent PPM include insertion of newer generation prosthetic valves with better hemodynamic characteristics, stentless prosthesis, aortic root enlargement to insert a larger prosthesis, aortic homograft, and transcutaneous AV implantation...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28369288/rapid-deployment-aortic-valve-replacement-for-severe-aortic-stenosis-1-year-outcomes-in-150-patients%C3%A2
#8
Alexis Theron, Eleonore Ravis, Dominique Grisoli, Nicolas Jaussaud, Pierre Morera, Pascal Candolfi, Jana Boleckova, David Lagier, Cecile Amanatiou, Lyna Messous, Vlad Gariboldi, Frederic Collart
OBJECTIVES: This study aimed to evaluate the safety and effectiveness of rapid-deployment aortic valve replacement (RDAVR) for severe aortic stenosis (AS). METHODS: All consecutive patients with severe AS who underwent RDAVR with the EDWARDS INTUITY bioprosthesis were prospectively included in a single-centre, cohort study between July 2012 and April 2015. Clinical examination and transthoracic echocardiography were performed preoperatively and at 1-month and 1-year follow-up...
March 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329317/patient-prosthesis-mismatch-in-new-generation-trans-catheter-heart-valves-a-propensity-score-analysis
#9
Alexis Theron, Johan Pinto, Dominique Grisoli, Karolina Griffiths, Erwan Salaun, Nicolas Jaussaud, Eléonore Ravis, Marc Lambert, Lyna Messous, Cecile Amanatiou, Thomas Cuisset, Vlad Gariboldi, Roch Giorgi, Gilbert Habib, Frederic Collart
Aims: When compared with the former Sapien XT (XT-THV), the Sapien 3 trans-catheter heart valve (S3-THV) embeds an outer annular sealing cuff to prevent para-valvular regurgitation (PVR). The consequences of this new feature on valve haemodynamics have never been evaluated. We aimed to compare both types of prostheses regarding patient-prosthesis mismatch (PPM). Methods and results: Patients who underwent a TAVR for aortic stenosis were retrospectively included...
February 27, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28329177/can-perceval-sutureless-valve-reduce-the-rate-of-patient-prosthesis-mismatch-%C3%A2
#10
Igor Belluschi, Stefano Moriggia, Andrea Giacomini, Benedetto Del Forno, Stefania Di Sanzo, Andrea Blasio, Antonio Scafuri, Ottavio Alfieri
OBJECTIVES: The aim of this study is to compare the theoretical incidence of patient-prosthesis mismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matching. METHODS: Between May 2012 and March 2016, 65 patients with severe symptomatic aortic stenosis underwent a sutureless aortic valve replacement with the Perceval bioprosthesis in 2 centres. Moreover, 177 aortic valve replacements with conventional sutured bioprosthesis were performed between August 2003 and September 2015...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28293311/aortic-annulus-enlargement-early-and-long-terms-results
#11
Selman Dumani, Ermal Likaj, Laureta Dibra, Vera Beca, Saimir Kuci, Ali Refatllari
AIM: Patient-prosthesis mismatch (PPM) is a common occurrence in aortic valve surgery. Even the discussions about the impact of this phenomenon on the results of aortic valve surgery, the management of this problem remain one of the main topics in this kind of surgery. One of the ways of a solution is aortic annulus enlargement. The main topic of this study is to evaluate the early and longterm results of this technique in our country. METHODS: During the period January 2010 -January 2015, 641 patients performed aortic valve surgery...
March 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28238241/mitral-patient-prosthesis-mismatch-predicts-suboptimal-hemodynamic-recovery-after-mitral-valve-replacement
#12
Sertan Ozyalcin, Kerem M Vural, Ayse Colak
BACKGROUND: A possible relationship between an obstructive prosthesis and suboptimal hemodynamic recovery, as reflected by unsatisfactory regression in systolic pulmonary artery pressure (sPAP) and functional tricuspid regurgitation (FTR) following mitral valve replacement (MVR), was investigated. A delineating effective orifice area index (EOAI) value was sought in order to define a patient-prosthesis mismatch. METHODS: A total of 128 patients undergoing isolated mechanical MVR were followed up for a mean of 46 ± 9 months...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28238235/prevalence-and-impact-of-prosthesis-patient-mismatch-following-surgical-aortic-valve-replacement-for-pure-aortic-regurgitation
#13
Vincent Auffret, Pierre Voisine, Alexandre Cinq-Mars, Éric Charbonneau, Florent Le Ven, Sacha-Michelle Dubois-Sénéchal, Eduardo Brenna, François Dagenais, Michelle Dubois, Carine Ridard, Mario Sénéchal
BACKGROUND: Prosthesis-patient mismatch (PPM) is highly prevalent among patients undergoing aortic valve replacement (AVR) to treat aortic stenosis. Data regarding the prevalence and impact of PPM on left ventricular remodeling and outcomes in patients who have undergone surgical AVR to treat pure severe aortic regurgitation (AR) are, however, scarce. METHODS: A retrospective analysis was conducted of clinical and echocardiographic data acquired from 50 consecutive patients with pure severe AR, without evidence of significant coronary artery disease, who underwent AVR between 2004 and 2010 at the authors' institution...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28212136/impact-of-different-values-of-prosthesis-patient-mismatch-on-outcome-in-male-patients-with-aortic-valve-replacement
#14
Vito A Mannacio, Luigi Mannacio, Anita Antignano, Giovanni B Pinna, Raffaele Giordano, Michele Mottola, Gabriele Iannelli
AIMS: Mortality and left ventricular mass (LVM) recovery/regression after aortic valve replacement in patients with prosthesis-patient mismatch (PPM) is controversial. This study evaluated the impact of different values of indexed effective orifice area (EOAi) in male patients on mortality and indexed LVM (ILVM) recovery/regression. METHOD: The study recruited 376 male patients with and without PPM after aortic valve replacement with different EOAi cut-off values...
February 15, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28132979/reducing-prosthesis-patient-mismatch-with-edwards-magna-prosthesis-for-aortic-valve-replacement
#15
Yuta Kume, Tomoyuki Fujita, Satsuki Fukushima, Hiroki Hata, Yusuke Shimahara, Yorihiko Matsumoto, Kizuku Yamashita, Junjiro Kobayashi
BACKGROUND: Prosthesis-patient mismatch (PPM) is associated with increased mid-term and long-term mortality rates after aortic valve replacement (AVR). This study aimed to evaluate the efficacy of the Carpentier-Edwards Perimount Magna and Magna Ease (CEPMs) aortic bioprostheses to reduce the incidence of PPM.Methods and Results:Altogether, 282 consecutive patients (113 women, mean age 69.9±9.9 years) underwent AVR with a CEPMs between 2008 and 2015. They were divided into 3 groups based on the risk of PPM as a result of their body surface area and aortic annular diameter (BSA/AnnD ratio): low-risk (LR) group: 0...
March 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28131425/evaluation-of-hemodynamic-performance-of%C3%A2-aortic-valve-bioprostheses-in-a-model-of%C3%A2-oversizing
#16
John D Cleveland, Michael E Bowdish, Carol E Eberhardt, Wendy J Mack, James A Crabtree, Thomas A Vassiliades, Alan M Speir, Yogesh A Darekar, Amy E Hackmann, Vaughn A Starnes, Robbin G Cohen
BACKGROUND: The risk of patient-prosthesis mismatch drives most surgeons to select the largest bioprosthesis possible during aortic valve replacement, but interactions between the native aortic annulus and valve prosthesis remain poorly defined. We examined the hemodynamic and functional consequences of oversizing contemporary bioprostheses in an in vitro model. METHODS: Three sizes each (21, 23, and 25 mm) of 5 aortic bioprostheses (Magna, Edwards Lifesciences, Irvine, CA; Trifecta and Epic, St...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28043449/stentless-vs-stented-aortic-valve-bioprostheses-in-the-small-aortic-root
#17
Laurens W Wollersheim, Wilson W Li, Abdullah Kaya, Berto J Bouma, Antoine H Driessen, Wim J van Boven, Jan van der Meulen, Bas A de Mol
In patients with a small aortic root undergoing aortic valve replacement (AVR), the Freedom SOLO bioprosthesis may be the ideal prosthesis because of its stentless design and supra-annular implantation. This study investigated if the stentless Freedom SOLO has an advantage when compared with a stented bioprosthesis in patients with a small aortic root. From April 2005-July 2014, 269 consecutive patients underwent AVR with either a Freedom SOLO (n = 76) or Mitroflow (n = 193) bioprosthesis size 19mm or 21mm, respectively...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28040758/stent-valve-implantation-in-conventional-redo-aortic-valve-surgery-to-prevent-patient-prosthesis-mismatch
#18
Enrico Ferrari, Giorgio Franciosi, Sara Clivio, Francesco Faletra, Marco Moccetti, Tiziano Moccetti, Giovanni Pedrazzini, Stefanos Demertzis
OBJECTIVES: The goal was to show the technical details, feasibility and clinical results of balloon-expandable stent valve implantation in the aortic position during conventional redo open-heart surgery in selected obese patients with a small aortic prosthesis and severe patient-prosthesis mismatch. METHODS: Two symptomatic overweight patients (body mass index of 31 and 38), each with a small aortic prosthesis (a 4-year-old, 21-mm Hancock II biological valve and a 29-year-old, 23-mm Duromedic mechanical valve), increased transvalvular gradients (59/31 and 74/44 mmHg) and a reduced indexed effective orifice area (0...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28028424/aortic-root-enlargement-or-sutureless-valve-implantation
#19
Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou
Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging issue. The importance of prosthesis-patient mismatch (PPM) post aortic valve replacement (AVR) is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28018817/transcatheter-valve-unable-to-cure-patient-prosthesis-mismatch-of-mosaic-bioprosthesis
#20
Daniela Serio, Andreas Zierer, Mirko Doss, Anton Moritz
Transcatheter aortic valve implantation (TAVI) has been recently established as a less invasive alternative to conventional aortic valve replacement (CAVR) in patients presenting with expected high procedural risk. The rapid technologic advances and the recent improvement of clinical outcomes with TAVI have made it possible to treat degenerated bioprosthesis using the valve-in-valve implantation concept (Walther T, Simon P, Dewey T, et al. Transapical minimally invasive aortic valve implantation: multicenter experience...
December 2016: Thoracic and Cardiovascular Surgeon Reports
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