title: Impact of patient-prosthesis mismatch on 30-day outcomes in young and middle-aged patients undergoing aortic valve replacement.
abstract: BACKGROUND
  The impact of patient-prosthesis mismatch (PPM) on early outcomes in young and middle-aged patients undergoing conventional aortic valve replacement for severe aortic stenosis remains unknown. Our objective was to evaluate the incidence of some degree of PPM and its influence on early mortality and morbidity.
  
  
  METHODS
  We analyzed our single center experience in all patients <70 years undergoing first-time isolated aortic valve replacement for severe stenosis in our center from September 2007 to September 2011. PPM was defined as an indexed effective orifice area ≤ 0,85 cm(2)/m(2). The influence of PPM on early mortality and postoperative complications was studied using propensity score analysis. Follow up at 30 postoperative days was 100% complete.
  
  
  RESULTS
  Of 199 patients studied, 61 (30,7%) had some degree of PPM. PPM was associated with an increased postoperative mortality (OR = 8,71; 95% CI = 1,67-45,29; p = 0,04) and major postoperative complications (OR = 2,96; CI = 1,03-8,55; p = 0,044). However, no association between PPM and prolonged hospital or ICU stay was demonstrated.
  
  
  CONCLUSIONS
  Moderate PPM is a common finding in young and middle-aged patients undergoing surgery for aortic valve replacement due to severe stenosis. In addition, its influence on early outcomes may be relevant.
authors.affiliation: Cardiac Surgery Department, Hospital Universitario Central de Asturias, Oviedo, Spain. dhvaquero@gmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Hernández-Vaquero
authors.forename: Juan C
authors.initials: JC
authors.lastname: Llosa
authors.forename: Rocío
authors.initials: R
authors.lastname: Díaz
authors.forename: Zain
authors.initials: Z
authors.lastname: Khalpey
authors.forename: Carlos
authors.initials: C
authors.lastname: Morales
authors.forename: Rubén
authors.initials: R
authors.lastname: Álvarez
authors.forename: Jose
authors.initials: J
authors.lastname: López
authors.forename: Francisco
authors.initials: F
authors.lastname: Boye
mesh_terms: D000328:Adult; D000368:Aged; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D015996:Survival Rate; D016896:Treatment Outcome