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Patient- prosthetic mismatch

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https://www.readbyqxmd.com/read/28502546/cryopreserved-saphenous-vein-as-a-last-ditch-conduit-for-limb-salvage
#1
Leigh Ann O'Banion, Bian Wu, Charles M Eichler, Linda M Reilly, Michael S Conte, Jade S Hiramoto
OBJECTIVE: In patients lacking autogenous vein suitable for infrainguinal bypass, cryopreserved saphenous vein (CSV) allograft (CryoLife, Inc, Kennesaw, Ga) may be an acceptable alternative. The purpose of this study was to examine outcomes of CSV conduit for infrainguinal revascularization. METHODS: Between February 2008 and August 2015, 70 patients underwent infrainguinal bypass grafts in 73 limbs using CSV. All patients lacked suitable arm or leg vein. Demographic data and patient outcomes were retrospectively collected using electronic medical records...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28431723/successful-biventricular-conversion-late-after-primary-one-and-one-half-ventricle-repair
#2
Takaya Hoashi, Masataka Kitano, Koji Kagisaki, Hajime Ichikawa
A 6-year-old girl with unbalanced atrioventricular septal defect, hypoplastic right ventricle, and severe common atrioventricular valve regurgitation developed patient-prosthetic mismatch. At 6 months old, she underwent primary one and one-half ventricle repair and replacement of left side atrioventricular valve. A catheter examination showed that her right ventricular end-diastolic volume increased from 39.4 mL/m(2) 1 year after to 70 mL/m(2) 3.5 years after the previous surgery. Thus, at the timing of redo left side atrioventricular valve replacement, she was converted successfully to biventricular circulation...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28393786/prosthesis-patient-mismatch-what-cardiac-anesthesiologists-need-to-know
#3
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/28259784/multi-directional-mechanical-analysis-of-synthetic-scaffolds-for-hernia-repair
#4
Savannah Est, Madeleine Roen, Tingying Chi, Adrian Simien, Ryan M Castile, Dominic M Thompson, Jeffrey A Blatnik, Corey R Deeken, Spencer P Lake
Hernias remain one of the most common ailments to affect men and women worldwide. Surgical mesh materials were first used to reinforce hernia defects during surgery in the late 1950s (Laker, n.d.). Today, there are well over 50 prosthetic meshes available for hernia repair (Brown and Finch, 2010; Bryan et al., 2014; Hope and El-hayek, 2014). With the multitude of available options, surgeons are faced with the challenging task of optimizing mesh selection for each patient. If the mechanics of the mesh are not compatible with the surrounding tissue, mismatch can occur, which can lead to complications such as mesh failure and/or hernia recurrence...
February 9, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28238241/mitral-patient-prosthesis-mismatch-predicts-suboptimal-hemodynamic-recovery-after-mitral-valve-replacement
#5
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/28131425/evaluation-of-hemodynamic-performance-of%C3%A2-aortic-valve-bioprostheses-in-a-model-of%C3%A2-oversizing
#6
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
#7
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/27955900/midterm-durability-and-hemodynamic-performance-of-a-third-generation-bovine-pericardial-prosthetic-aortic-valve-the-leipzig-experience
#8
Sven Lehmann, Anna Meyer, Thomas Schroeter, Madlen Uhlemann, Julia Fischer, Sergey Leontyev, Jens Garbade, David Holzhey, Martin Misfeld, Friedrich-Wilhelm Mohr
BACKGROUND: The Trifecta valve (St. Jude Medical, St. Paul, MN) is a stented bovine pericardial bioprosthesis for aortic valve replacement (AVR). Implantation experience and midterm follow-up of this valve have not yet been reported from a large single-center cohort. METHODS: We retrospectively analyzed data from 918 patients (73.2 ± 6.5 years; logistic European System for Cardiac Operative Risk Evaluation [EuroSCORE], 13.2 ± 14.3) who underwent AVR. Analyses addressed implantation safety, short- and long-term survival, and hemodynamic valve performance...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27873034/on-the-mechanics-of-transcatheter-aortic-valve-replacement
#9
Lakshmi P Dasi, Hoda Hatoum, Arash Kheradvar, Ramin Zareian, S Hamed Alavi, Wei Sun, Caitlin Martin, Thuy Pham, Qian Wang, Prem A Midha, Vrishank Raghav, Ajit P Yoganathan
Transcatheter aortic valves (TAVs) represent the latest advances in prosthetic heart valve technology. TAVs are truly transformational as they bring the benefit of heart valve replacement to patients that would otherwise not be operated on. Nevertheless, like any new device technology, the high expectations are dampened with growing concerns arising from frequent complications that develop in patients, indicating that the technology is far from being mature. Some of the most common complications that plague current TAV devices include malpositioning, crimp-induced leaflet damage, paravalvular leak, thrombosis, conduction abnormalities and prosthesis-patient mismatch...
February 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27867654/patient-prosthesis-mismatch-surgical-aortic-valve-replacement-versus-transcatheter-aortic-valve-replacement-in-high-risk-patients-with-aortic-stenosis
#10
COMMENT
Ravi K Ghanta, Irving L Kron
Patient prosthesis mismatch (PPM) can occur when a prosthetic aortic valve has an effective orifice area (EOA) less than that of a native valve. A recent study by Zorn and colleagues evaluated the incidence and significance of PPM in high risk patients with severe aortic stenosis who were randomized to transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). TAVR is associated with decreased incidence of severe PPM compared to traditional SAVR valves. Severe PPM increases risk for death at 1 year postoperatively in high risk patients...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27697360/mid-term-durability-of-the-trifecta-bioprosthesis-for-aortic-valve-replacement
#11
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...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27687067/prosthesis-patient-mismatch-after-aortic-valve-replacement
#12
REVIEW
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
https://www.readbyqxmd.com/read/27624355/impact-of-prosthesis-patient-mismatch-on-early-haemodynamic-status-after-aortic-valve-replacement
#13
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...
January 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27576330/subacute-left-ventricular-outflow-tract-obstruction-after-transapical-closure-of-a-mitral-paravalvular-leak-in-the-region-of-the-aortomitral-curtain
#14
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.
November 2016: Echocardiography
https://www.readbyqxmd.com/read/27566959/relative-prosthesis-patient-mismatch-after-transcatheter-aortic-valve-replacement-the-impact-of-morbid-obesity
#15
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
https://www.readbyqxmd.com/read/27245785/old-myths-new-concerns-the-long-term-effects-of-ascending-aorta-replacement-with-dacron-grafts-not-all-that-glitters-is-gold
#16
REVIEW
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
https://www.readbyqxmd.com/read/27033408/midterm-follow-up-of-the-stentless-freedom-solo-bioprosthesis-in-350-patients
#17
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
https://www.readbyqxmd.com/read/27004041/pannus-related-prosthetic-valve-dysfunction-case-report
#18
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)
https://www.readbyqxmd.com/read/26921981/prosthesis-patient-mismatch-after-aortic-valve-replacement-effect-on-long-term-survival
#19
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
https://www.readbyqxmd.com/read/26876065/incidence-of-prosthesis-patient-mismatch-in-patients-receiving-mitral-biocor%C3%A2-porcine-prosthetic-valves
#20
MULTICENTER STUDY
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
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