title: Patient prosthesis mismatch after aortic valve replacement: An Indian perspective.
abstract: BACKGROUND
  Perioperative period.
  
  
  OBJECTIVE
  Occurrence of PPM after AVR, factors associated with PPM, impact on mortality.
  
  
  METHODS
  Teritary Care Referral Cardiac Centre.
  
  
  METHODS
  A retrospective analysis of AVR procedures at a single centre over 4 years was conducted. Demographic, echocardiographic and outcome data were collected from institute database. Rahimtoola criteria of indexed effective orifice area (iEOA) were used to stratify patients into PPM categories. Patients with and without PPM were compared for associated factors.
  
  
  METHODS
  Independent t-test, chi-square test, logistic regression analysis, ROC-AUC, Youden index.
  
  
  RESULTS
  606 patients with complete data were analysed for PPM. The incidence of mild, moderate and severe PPM was 6.1% (37), 2.5% (15) and 0.5% (3) respectively. There was no impact of PPM on all-cause in-hospital mortality. PPM was observed more with Aortic Stenosis (AS) compared to Aortic Regurgitation (AR) as etiology. Aortic annulus indexed to BSA (iAA) had a very good predictive ability for PPM at <16mm/m 2 BSA.
  
  
  CONCLUSIONS
  PPM has lower incidence after AVR in this Indian population and does not increase early mortality. Patients with AS and iAA<16mm/m2BSA should be cautiously dealt with to prevent PPM.
authors.affiliation: Department of Cardiac Anaesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Shreedhar S
authors.initials: SS
authors.lastname: Joshi
authors.forename: T
authors.initials: T
authors.lastname: Ashwini
authors.forename: Antony
authors.initials: A
authors.lastname: George
authors.forename: A M
authors.initials: AM
authors.lastname: Jagadeesh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000453:epidemiology / Q000209:etiology; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000209:etiology; D019540:Area Under Curve; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007194:India; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography