title: Patient-prosthesis mismatch in patients with aortic valve replacement.
abstract: OBJECTIVE
  Patient-prosthesis mismatch (PPM) may affect clinical outcomes in patients with aortic valve replacement (AVR). We retrospectively examined the PPM in patients with isolated AVR in the Japan Adult Cardiovascular Surgery Database (JACVSD).
  
  
  METHODS
  We examined all patients with isolated AVR between January 1, 2008 and December 31, 2009. The JACVSD data collection form has a total of 255 variables. We defined PPM as an effective orifice area index of ≤ 0.85 m(2)/cm(2).
  
  
  RESULTS
  PPM was observed in 306 of 3,609 cases analyzed, PPM rate was 8.5 %. Body surface area was larger and body mass index was higher in the PPM group than the non-PPM group (P < 0.001). Patients with PPM were older (P = 0.001) and had a higher prevalence of diabetes (P = 0.004), dyslipidemia (P < 0.001), hypertension (P < 0.001), cerebrovascular disease (P = 0.031), old myocardial infarction (P = 0.006), previous percutaneous coronary artery intervention (P = 0.001), coronary artery disease (P = 0.018), and aortic valve stenosis (P < 0.001). Perioperative blood transfusion (P < 0.001) and dialysis (P = 0.005) were more frequent in the PPM group. Postoperative ventilation (P = 0.004) and intensive care unit stay (P = 0.004) were significantly longer in the PPM group.
  
  
  CONCLUSIONS
  Age, aortic valve stenosis, dyslipidemia, hypertension, old myocardial infarction, previous percutaneous coronary artery intervention, diabetes mellitus, cerebrovascular disease, and high body mass index were the risk factors for PPM. PPM was not an independent risk factor for short-term mortality.
authors: Division of Cardiovascular Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. tcvkamyu@jichi.ac.jp
authors: Yuichiro
authors: Y
authors: Kaminishi
authors: Yoshio
authors: Y
authors: Misawa
authors: Junjiro
authors: J
authors: Kobayashi
authors: Hiroaki
authors: H
authors: Konishi
authors: Hiroaki
authors: H
authors: Miyata
authors: Noboru
authors: N
authors: Motomura
authors: Shin-ichi
authors: S
authors: Takamoto
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000033:anatomy & histology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D015992:Body Mass Index; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012016:Reference Values; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
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