title: Reducing Prosthesis-Patient Mismatch With Edwards Magna Prosthesis for Aortic Valve Replacement.
abstract: Prosthesis-patient mismatch (PPM) is associated with increased mid-term and long-term mortality rates after aortic valve replacement (AVR). This study aimed to evaluate the efficacy of the Carpentier-Edwards Perimount Magna and Magna Ease (CEPMs) aortic bioprostheses to reduce the incidence of PPM.
  
  
  
  Altogether, 282 consecutive patients (113 women, mean age 69.9±9.9 years) underwent AVR with a CEPMs between 2008 and 2015. They were divided into 3 groups based on the risk of PPM as a result of their body surface area and aortic annular diameter (BSA/AnnD ratio): low-risk (LR) group: 0.64±0.05 m2/cm (n=94); medium-risk (MR) group: 0.73±0.02 m2/cm (n=94); high-risk (HR) group: 0.83±0.05 m2/cm (n=94). The 30-day mortality rate was 0.4%. The 5-year actuarial survival rates were 93.2%, 92.3%, and 94.8% for groups LR, MR, and HR, respectively. No explants as a result of structural valve deterioration occurred. No patients showed severe PPM, defined as a measured effective orifice area index (EOAI) <0.65 cm2/m2. Although there were significant (P<0.05) differences in EOAI (0.98±0.2, 0.90±0.21, and 0.88±0.1 cm2/m2among the LR, MR, and HR groups, respectively), the corresponding transvalvular mean pressure gradients (13.0±5.5, 12.3±4.0, 12.7±5.3 mmHg) and regression rates of the left ventricular mass (29.8%, 28.7%, 28.9%) were similar among groups.
  
  
  
  CEPMs provide low surgical risk and reduce the risks of PPM, even in HR patients, with excellent hemodynamics.
authors.affiliation: Department of Cardiac Surgery, National Cerebral and Cardiovascular Center.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Kume
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Satsuki
authors.initials: S
authors.lastname: Fukushima
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hata
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shimahara
authors.forename: Yorihiko
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Kizuku
authors.initials: K
authors.lastname: Yamashita
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis / Q000592:standards*; D005260:Female; D006350:Heart Valve Prosthesis / Q000592:standards*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D015996:Survival Rate