Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2011;64:774-9 - Vol. 64 Num.09 DOI: 10.1016/j.rec.2011.05.012

Influence of Patient-Prosthesis Mismatch in the Octogenarian Undergoing Surgery for Aortic Valve Replacement Due to Severe Stenosis

Daniel Hernandez-Vaquero a,, David Calvo b, Jose M. Garcia b, Íñigo Lozano b, Carlos Morales a, Jose Luis Naya a, Cesar Moris b, Juan C. Llosa a

a Servicio de Cirugía Cardiovascular, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
b Servicio de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain

Keywords

Aortic valve stenosis. Octogenarians. Patient-prosthesis mismatch.

Abstract

Introduction and objectives

The clinical impact of patient-prosthesis mismatch on the outcome in octogenarians who undergo surgery for aortic valve replacement due to severe stenosis is unknown. Our objective was to quantify the frequency of some degree of patient-prosthesis mismatch and its impact on mortality and life quality.

Methods

We analyzed all the octogenarian patients who underwent surgery for aortic valve replacement due to severe stenosis in our center from February 2004 to April 2009. Patient-prosthesis mismatch was considered to exist when the indexed effective orifice area was ≤0.85cm2/m2. The influence of patient-prosthesis mismatch on in-hospital mortality, medium-term survival, and New York Heart Association functional class was studied using an analysis adjusted for propensity score.

Results

Of 149 patients studied, 61.7% had some degree of patient-prosthesis mismatch (mean follow-up was 32.71±14.42 months). After adjusting for propensity score, there were no differences in in-hospital mortality (odds ratio=0.75; 95% confidence interval, 0.15-3.58; P=.72), medium-term survival (hazard ratio=1; 95% confidence interval, 0.36-2.78; P=.99) or functional class during follow-up (odds ratio=1.46; 95% confidence interval, 0.073-29.24; P=.8).

Conclusions

Although moderate patient-prosthesis mismatch is a very common finding in octogenarian patients who undergo aortic valve replacement, its influence on mortality and quality of life does not seem to be relevant. The biological profile of elderly patients with lower metabolic requirements and limited physical activity could justify the results obtained.

1885-5857/© 2011 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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