title: Impact of different values of prosthesis-patient mismatch on outcome in male patients with aortic valve replacement.
abstract: OBJECTIVE
  Mortality and left ventricular mass (LVM) recovery/regression after aortic valve replacement in patients with prosthesis-patient mismatch (PPM) is controversial. This study evaluated the impact of different values of indexed effective orifice area (EOAi) in male patients on mortality and indexed LVM (ILVM) recovery/regression.
  
  
  METHODS
  The study recruited 376 male patients with and without PPM after aortic valve replacement with different EOAi cut-off values.
  
  
  RESULTS
  At EOAi 0.85 cm/m or less, 295 patients had PPM (78.5%). ILVM recovery occurred in 60.5% of no-PPM patients versus 46.1% of patients with PPM (P = 0.003), and ILVM regression was 35 versus 25% (P < 0.001). Time for ILVM regression was shorter in no-PPM group. At EOAi 0.75 cm/m or less, 201 patients had PPM (53.4%). ILVM recovery occurred in 55.4% of no-PPM patients versus 45.2% of patients with PPM (P = 0.06), regression was 32 versus 29% (P = 0.09). Time for ILVM regression was similar between groups. Regardless the cut-off value for PPM definition, mortality was similar.
  
  
  CONCLUSIONS
  LVM recovery/regression, but not mortality, was different at different EOAi. The cut-off value at EOAi 0.75 cm/m or less guaranteed a more balanced patient distribution between groups and the best compromise between specificity and sensitivity.
authors.affiliation: aDepartment of Cardiac Surgery, University Federico II, School of Medicine bDepartment of Cardiology, Azienda Ospedaliera Santobono-Pausillipon, Naples, Italy.
authors.forename: Vito A
authors.initials: VA
authors.lastname: Mannacio
authors.forename: Luigi
authors.initials: L
authors.lastname: Mannacio
authors.forename: Anita
authors.initials: A
authors.lastname: Antignano
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Pinna
authors.forename: Raffaele
authors.initials: R
authors.lastname: Giordano
authors.forename: Michele
authors.initials: M
authors.lastname: Mottola
authors.forename: Gabriele
authors.initials: G
authors.lastname: Iannelli
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016208:Databases, Factual; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling