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Patient Prosthesis mismatch

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https://www.readbyqxmd.com/read/28329317/patient-prosthesis-mismatch-in-new-generation-trans-catheter-heart-valves-a-propensity-score-analysis
#1
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
#2
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...
February 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28293311/aortic-annulus-enlargement-early-and-long-terms-results
#3
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
#4
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
#5
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
#6
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
#7
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...
January 27, 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
#8
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...
January 26, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28043449/stentless-vs-stented-aortic-valve-bioprostheses-in-the-small-aortic-root
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27989082/impact-of-prosthesis-patient-mismatch-after-mitral-valve-replacement
#13
Calogera Pisano, Carmela Rita Balistreri, Oreste Fabio Triolo, Rosalba Franchino, Alberto Allegra, Veronica Capuccio, Vincenzo Argano, Giovanni Ruvolo
BACKGROUND: The study aim was to determine the impact of prosthesis-patient mismatch (PPM) on early and late clinical outcomes, left atrial and ventricular remodeling, late tricuspid valve regurgitation and pulmonary hypertension (PH) in patients after mitral valve replacement (MVR). METHODS: A total of 46 patients (mean age 66 ± 9.3 years) with mitral valve diseases and undergoing isolated MVR was enrolled in the study. The mitral valve effective orifice area (EOA) was determined using the continuity equation and indexed for the patient's body surface area (EOAi)...
January 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27955900/midterm-durability-and-hemodynamic-performance-of-a-third-generation-bovine-pericardial-prosthetic-aortic-valve-the-leipzig-experience
#14
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...
December 9, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27939031/early-hemodynamics-and-clinical-outcomes-of-isolated-aortic-valve-replacement-with-stentless-or-transcatheter-valve-in-intermediate-risk-patients
#15
Alberto Repossini, Lorenzo Di Bacco, Bruno Passaretti, Herko Grubitzsch, Christina Schäfer, Benjamin Claus, Laura Giroletti, Thierry Folliguet, Gianluigi Bisleri, Theodor Fischlein, Giuseppe Santarpino, Roberto Di Bartolomeo, François Laborde, Claudio Muneretto
OBJECTIVE: Stentless aortic valves have been developed to overcome obstructive limitations associated with stented bioprostheses. The aim of the current multi-institutional study was to compare hemodynamics of transcatheter (TAVR) and the Freedom SOLO Stentless (FS) valve in an intermediate risk population undergoing surgical aortic valve replacement. METHODS: From 2010 to 2014, 420 consecutive patients underwent isolated surgical aortic valve replacement with FS and 375 patients underwent TAVR...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27873034/on-the-mechanics-of-transcatheter-aortic-valve-replacement
#16
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
#17
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/27866867/impact-of-mild-patient-prosthesis-mismatch-on-quality-of-life-in-patients-with-preserved-ejection-fraction-after-isolated-aortic-valve-replacement-for-aortic-stenosis
#18
Vlatka Reskovic Luksic, D Dosen, M Pasalic, Jadranka Separovic Hanzevacki
AIM: To analyze whether PPM affects QOL and functional status in patients after isolated AVR for aortic stenosis (AS) with preserved left ventricular ejection fraction (LVEF). METHODS: Consecutive patients who underwent AVR in University Hospital Center Zagreb for isolated severe symptomatic AS and preserved EF were enrolled. Echo data was obtained from complete transthoracic examinations prior and after surgery by offline analysis. Patients were divided into two groups according to the presence of PPM (effective orifice area (EOA)/body surface area (BSA)<0,85cm(2)/m(2))...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27849298/long-term-mortality-predictors-in-patients-with-small-aortic-annulus-undergoing-aortic-valve-replacement-with-a-19-or-21-mm-bioprosthesis
#19
Jenny Lourdes Rivas de Oliveira, Renato Tambellini Arnoni, Magaly Arrais Dos Santos, Antonio Flávio Sanchez Almeida, Mário Issa, Antoninho Sanfins Arnoni, Paulo Chaccur, Luiz Carlos Bento de Souza
Introduction: Replacement of the aortic valve in patients with a small aortic annulus is associated with increased morbidity and mortality. A prosthesis-patient mismatch is one of the main problems associated with failed valves in this patient population. Objective: To evaluate the long-term mortality predictors in patients with a small aortic annulus undergoing aortic valve replacement with a bioprosthesis. Methods: In this retrospective observational study, a total of 101 patients undergoing aortic valve replacement from January 2000 to December 2010 were studied...
July 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27703574/aortic-annular-enlargement-during-aortic-valve-replacement
#20
Selman Dumani, Ermal Likaj, Laureta Dibra, Stavri Llazo, Ali Refatllari
In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
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