Moderate Prosthesis-Patient Mismatch May Be Negligible in Elderly Patients Undergoing Conventional Aortic Valve Replacement for Aortic Stenosis

Tadashi Kitamura; Shinzo Torii; Naoji Hanayama; Norihiko Oka; Takahiro Tomoyasu; Yusuke Irisawa; Miyuki Shibata; Hidenori Hayashi; Takamichi Inoue; Kagami Miyaji

doi:10.1536/ihj.54.11

Clinical Studies

Moderate Prosthesis-Patient Mismatch May Be Negligible in Elderly Patients Undergoing Conventional Aortic Valve Replacement for Aortic Stenosis

Tadashi Kitamura, Shinzo Torii, Naoji Hanayama, Norihiko Oka, Takahiro Tomoyasu, Yusuke Irisawa, Miyuki Shibata, Hidenori Hayashi, Takamichi Inoue, Kagami Miyaji

Author information

Tadashi Kitamura
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Shinzo Torii
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Naoji Hanayama
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Norihiko Oka
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Takahiro Tomoyasu
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Yusuke Irisawa
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Miyuki Shibata
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Hidenori Hayashi
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Takamichi Inoue
Department of Cardiovascular Surgery, Kitasato University School of Medicine
Kagami Miyaji
Department of Cardiovascular Surgery, Kitasato University School of Medicine

Keywords: Cardiac surgery, Outcomes

JOURNAL FREE ACCESS

2013 Volume 54 Issue 1 Pages 11-14

DOI https://doi.org/10.1536/ihj.54.11

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Abstract

Together with aging of the Japanese population, aortic valve replacement (AVR) for aortic stenosis (AS) is now becoming more and more common in the elderly. When the aortic annulus is too small to allow an adequate sized prosthetic valve, aortic root enlargement is required to avoid prosthesis-patient mismatch (PPM). However, age-related comorbidities including aortic root calcification bring significant risk in performing aortic root enlargement. In the present study, 40 patients aged 75 years or more who underwent AVR for AS were reviewed to determine whether moderate PPM has a negative impact on the long-term results. Operative mortality occurred in 2 patients (5%) and moderate PPM occurred in 8 patients. There was no significant difference in survival between cases with and without PPM (P = 0.87). Both aortic pressure gradient (PG) and left ventricular mass index (LVMI) measured by echocardiography were signifi cantly decreased in patients with and without PPM. Reduction of PG was significantly greater in patients with PPM than without PPM (P = 0.02). Reduction of LVMI was not different between the groups (P = 0.58). Moderate PPM did not negatively influence survival or reduction of PG or LVMI in patients aged 75 years or older who underwent AVR for AS.

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