Predicting patient–prosthesis mismatch by aortic root evaluation before aortic valve replacement

The Journal of Thoracic and Cardiovascular Surgery

Koichi Maeda¹  Toru Kuratani² 

[1] Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan;Division of Biostatistics, Department of Data Management, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan

关键词: aortic valve stenosis;    patient-prosthesis mismatch;    multislice computed tomography;   

DOI  :  10.1016/j.jtcvs.2018.11.103

学科分类：心脏病和心血管学

来源: Mosby, Inc.

【 摘 要 】

ObjectiveThis study aimed to assess the predictors of patient–prosthesis mismatch (PPM) after surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) using preoperative computed tomography.MethodsWe enrolled 323 patients undergoing SAVR (n = 85) or TAVR (n = 238) for aortic stenosis. The end point was any degree of PPM (effective orifice area index 2/m2). We assessed the predictors of PPM after SAVR or TAVR and compared the incidence of PPM between both arms. Furthermore, we compared the hemodynamic performance using the propensity score matching.ResultsThe occurrence of PPM was significantly higher in the SAVR arm (24.7% vs 7.1%; P P = .015), but not a significant predictor in the TAVR arm. In patients with a small sinotubular junction, the prevalence of PPM in the SAVR arm was higher (57.9% vs 2.9%; P P = .031).ConclusionsIn patients with a small sinotubular junction detected by preoperative computed tomography assessment, the incidence of PPM in patients undergoing SAVR was higher.

【 授权许可】

Unknown