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Patient- prosthetic mismatch

Amedeo Anselmi, Vito Giovanni Ruggieri, Bernard Lelong, Erwan Flecher, Hervé Corbineau, Thierry Langanay, Jean-Philippe Verhoye, Alain Leguerrier
OBJECTIVE: To clarify the mid-term durability of the Trifecta bioprosthesis for aortic valve replacement (AVR). METHODS: We retrospectively analyzed the prospectively collected data of 824 consecutive implants of the Trifecta valve at a single institution. A 100% complete follow-up was available (average duration, 2.2 ± 1.3 years; range, 0.03-6.9 years; 1747.6 patient-years). Echocardiography data at discharge were recorded prospectively. RESULTS: Operative mortality was 3...
August 30, 2016: Journal of Thoracic and Cardiovascular Surgery
Abdellaziz Dahou, Haïfa Mahjoub, Philippe Pibarot
Prosthesis-patient mismatch (PPM) occurs when the effective orifice area (EOA) of a normally functioning prosthesis is too small in relation to the patient's body size, resulting in abnormally high postoperative gradients. PPM is frequent following aortic valve replacement (AVR), and it is associated with increased risk of morbidity and mortality proportionally to its severity. Differential diagnosis between PPM and prosthetic valve stenosis is made by comparing the measured valve effective orifice area, by assessing the changes in valve area and gradient during follow-up and by evaluating leaflet morphology and mobility...
November 2016: Current Treatment Options in Cardiovascular Medicine
Michel Kindo, Tam Hoang Minh, Stéphanie Perrier, Hélène Petit-Eisenmann, Jonathan Bentz, Mircea Cristinar, Gharib Ajob, Olivier Collange, Jean-Philippe Mazzucotelli
OBJECTIVES: Prosthesis-patient mismatch (PPM) has been reported to impact early haemodynamic status and early mortality after prosthetic aortic valve replacement (AVR) in patients with aortic stenosis (AS). The aim of this study was to assess the impact of PMM on early haemodynamic status after AVR using vasoactive-inotropic dependency index (VDI), postoperative pressures and end-organ perfusion. METHODS: A total of 183 patients with AS were included in this prospective cohort study, and underwent elective AVR with or without combined coronary artery bypass graft surgery...
September 13, 2016: Interactive Cardiovascular and Thoracic Surgery
Sathish Chikkabyrappa, Doff B McElhinney, Muhamed Saric
We report a rare case of progressive left ventricular outflow tract (LVOT) obstruction after percutaneous device closure of a mechanical prosthetic mitral valve (MV) paravalvular leak (PVL) in the region of aortomitral curtain in a patient who also had small mechanical aortic valve prosthesis with patient-prosthesis mismatch.
August 30, 2016: Echocardiography
Sophia Airhart, Ivan Medvedev, Larry S Dean
Prosthesis-patient mismatch (PPM) is defined as a small effective orifice area (EOA) of a normally functioning prosthetic valve in relation to patient body size. Even moderate impediment to forward flow has been associated with an increase in all-cause mortality. We report an unusual cause of PPM where a transcatheter implantation of a large EOA valve in an aortic position results in relative PPM in a patient with morbid obesity. © 2016 Wiley Periodicals, Inc.
August 27, 2016: Catheterization and Cardiovascular Interventions
Cristiano Spadaccio, Francesco Nappi, Nawwar Al-Attar, Fraser W Sutherland, Christophe Acar, Antonio Nenna, Marcella Trombetta, Massimo Chello, Alberto Rainer
Synthetic grafts are widely used in cardiac and vascular surgery since the mid-1970s. Despite their general good performance, inability of mimicking the elastomechanical characteristics of the native arterial tissue, and the consequent lack of adequate compliance, leads to a cascade of hemodynamic and biological alterations deeply affecting cardiovascular homeostasis. Those concerns have been reconsidered in more contemporaneous surgical and experimental reports which also triggered some research efforts in the tissue engineering field towards the realization of biomimetic arterial surrogates...
August 2016: Journal of Cardiovascular Translational Research
Laurens W Wollersheim, Wilson W Li, Berto J Bouma, Abdullah Kaya, Wim J van Boven, Jan van der Meulen, Bas A de Mol
BACKGROUND: The stentless Freedom Solo aortic bioprosthesis is implanted supraannularly using one running suture line in the sinuses of Valsalva. We report our 9-year experience with this bioprosthesis. METHODS: From April 2005 to July 2014, 350 consecutive patients at our institution underwent aortic valve replacement with the Freedom Solo bioprosthesis. Follow-up and echocardiographic data were collected retrospectively from referring cardiology centers. RESULTS: The mean age was 76 ± 6 years, 48% were male, and 46% underwent a concomitant procedure...
July 2016: Annals of Thoracic Surgery
Maria-Sînziana Moldovan, Daniela Bedeleanu, Emese Kovacs, Lorena Ciumărnean, Adrian Molnar
Pannus-related prosthetic valve dysfunction, a complication of mechanical prosthetic valve replacement, is rare, with a slowly progressive evolution, but it can be acute, severe, requiring surgical reintervention. We present the case of a patient with a mechanical single disc aortic prosthesis, with moderate prosthesis-patient mismatch, minor pannus found on previous ultrasound examinations, who presented to our service with angina pain with a duration of 1 hour, subsequently interpreted as non-ST segment elevation myocardial infarction (NSTEMI) syndrome...
2016: Clujul Medical (1957)
Ben M Swinkels, Bas A de Mol, Johannes C Kelder, Freddy E Vermeulen, Jurriën M ten Berg
BACKGROUND: Mean follow-up in previous studies on the effect of prosthesis-patient mismatch on long-term survival after aortic valve replacement (AVR) is confined to a maximum of one decade. This retrospective longitudinal cohort study was performed to determine the effect on long-term survival of prosthesis-patient mismatch after AVR with a mean follow-up of almost two decades. METHODS: Kaplan-Meier survival analysis was used to determine long-term survival after AVR in a cohort of 673 consecutive patients, divided into 163 patients (24...
April 2016: Annals of Thoracic Surgery
Raul A Borracci, Miguel Rubio, Maria L Sestito, Carlos A Ingino, Carlos Barrero, Carlos A Rapallo
BACKGROUND: The aim was to assess the incidence of prosthesis-patient mismatch (PPM) after mitral valve replacement (MVR) in patients receiving Biocor® porcine or mechanical valves, and to evaluate the effect of PPM on long-term survival. METHODS: All patients undergoing MVR between 2009 and 2013 received either mechanical or bioprosthetic valves (Biocor® porcine). PPM was defined as severe when the indexed effective ori-fice area was < 0.9 cm2/m2, moderate between 0...
2016: Cardiology Journal
In Jeong Cho, Geu Ru Hong, Seung Hyun Lee, Sak Lee, Byung Chul Chang, Chi Young Shim, Hyuk Jae Chang, Jong Won Ha, Namsik Chung
PURPOSE: The incidence of prosthesis-patient mismatch (PPM) after mitral valve replacement (MVR) has been reported to vary. The purpose of the current study was to investigate incidence of PPM according to the different methods of calculating effective orifice area (EOA), including the continuity equation (CE), pressure half time (PHT) method and use of reference EOA, and to compare these with various echocardiographic variables. MATERIALS AND METHODS: We retrospectively reviewed 166 individuals who received isolated MVR due to rheumatic mitral stenosis and had postoperative echocardiography performed between 12 and 60 months after MVR...
March 2016: Yonsei Medical Journal
Kenji Minakata, Ryuzo Sakata
No abstract text is available yet for this article.
2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Orhan Gokalp, Bortecin Eygi, Yuksel Besir, Gamze Gokalp, Ali Gurbuz
No abstract text is available yet for this article.
2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Noah Barka, Jason Bourgoin, Erin Grassl, John A St Cyr
OBJECTIVE: Prosthetic heart valve implantation is commonly performed in patients that have valvular heart disease. Prior to clinical evaluation of newly developed prostheses, preclinical animal studies are performed for the assessment of both acute and chronic valvular function. Commonly, one size of valve is used in these preclinical studies, which can present difficulties with the implantation procedure and assessing valve function. Due to these potential problems, we developed a preoperative screening assessment in potential ovine candidates for prosthetic aortic valve implantation...
August 2016: Therapeutic Advances in Cardiovascular Disease
Michelle Frank, Giulia Ganzoni, Christoph Starck, Jürg Grünenfelder, Roberto Corti, Christiane Gruner, David Hürlimann, Felix C Tanner, Rolf Jenni, Matthias Greutmann, Patric Biaggi
Incomplete information on characteristics of prosthetic heart valves (PHV) may lead to inappropriate choices for PHV implantation (patient-prosthesis-mismatch) or erroneous interpretation of PHV function after implantation. No single and easy accessible source provides all relevant information on PHV. The aim of this study was to provide a comprehensive overview of available data for the majority of PHVs and annuloplasty rings. Information was collected by reviewing articles published on up to December 2014 and by written contact to all PHV manufacturers...
March 2016: International Journal of Cardiovascular Imaging
Luis Rodriguez-Ospina, Juan Garcia-Morell, Carla P Rodriguez-Monserrate, Julio Valentin-Nieves
Valve replacement is the standard surgical treatment of diseased valves that cannot be repaired. The main goal of replacement is to exchange the diseased valve with one that has the engineering and hemodynamics as close as possible to the disease free native valve. However due to mechanical and fluid dynamic constraints all prosthetic heart valves (PHVs) are smaller than normal and thus are inherently stenotic. This represents a challenge when it comes time to replace a valve. The correct valve with the correct and matching profile has to be selected before the procedure to avoid possible complications...
April 2015: Boletín de la Asociación Médica de Puerto Rico
Elena Sportelli, Tommaso Regesta, Antonio Salsano, Paola Ghione, Carlotta Brega, Gian Paolo Bezante, Giancarlo Passerone, Francesco Santini
BACKGROUND: To evaluate the impact of patient-prosthesis mismatch (PPM) on survival, functional status, and quality of life (QoL) after aortic valve replacement (AVR) with small prosthesis size in elderly patients. METHODS: Between January 2005 and December 2013, 152 patients with pure aortic stenosis, aged at least 75 years, underwent AVR, with a 19 or 21 mm prosthetic heart valve. PPM was defined as an indexed effective orifice area less than 0.85 cm/m. Median age was 82 years (range 75-93 years)...
February 2016: Journal of Cardiovascular Medicine
Massimiliano Gessaroli, Salvatore Tarantini, Michele Leone, Elisabetta Fabbri, Ilaria Panzini
BACKGROUND: The purpose of this study was to evaluate our results involving femorocrural bypasses by comparing heparin-bonded expanded polytetrafluoroethylene (HePTFE) graft (Propaten) modified with handmade distal compliant HePTFE cuffs (mHePTFE graft) to great saphenous vein (GSV) graft. METHODS: A retrospective study involving 74 femorocrural bypasses performed from January 2010 to May 2013 at a single institution was carried out. The indication for revascularization was critical limb ischemia (Rutherford stages 4-6...
August 2015: Annals of Vascular Surgery
Sohail Ikram, Sadip Pant, Zeeshan Hussain, Lorrel Brown
Prosthetic valve thrombosis (PVT) is a rare but potentially fatal complication of mechanical valve prosthesis. The differential diagnoses for prosthetic valve obstruction includes pannus formation, prosthetic valve dehiscence, prosthetic valve endocarditis, chordae entrapment, patient-prosthesis mismatch and primary device failure. Establishing a diagnosis requires an understanding of prosthetic valve haemodynamics and careful correlation of clinical and imaging findings. Definitive therapy must be individualised based on various patient-specific factors...
2015: BMJ Case Reports
Jérôme Laflamme, Rishi Puri, Marina Urena, Louis Laflamme, Hugo DeLarochellière, Omar Abdul-Jawad Altisent, Maria del Trigo, Francisco Campelo-Parada, Robert DeLarochellière, Jean-Michel Paradis, Eric Dumont, Daniel Doyle, Siamak Mohammadi, Mélanie Côté, Philippe Pibarot, Vinçent Laroche, Josep Rodés-Cabau
There are currently no data evaluating the hematologic and biocompatibility profile of transcatheter aortic valves in vivo. We evaluated the incidence, predictive factors, and clinical consequences associated with hemolysis post-transcatheter aortic valve implantation (TAVI). A total of 122 patients who underwent TAVI with a balloon-expandable valve were included. Baseline blood sampling and echocardiography, followed by early post-TAVI echocardiography and repeat blood sampling, at 6 to 12 months post-TAVI were performed...
June 1, 2015: American Journal of Cardiology
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