Association of Valve Size and Hemodynamic Performance With Clinical Outcomes in Aortic Valve Replacement-A Long-Term Follow-up in an Asian Population

Yi Yen, Kuo Chun Hung, Yi Hsin Chan, Victor Chien Chia Wu, Yu Ting Cheng, Chia Pin Lin, Jih Kai Yeh, Pao-Hsien Chu, Shao Wei Chen*

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

摘要

BACKGROUND: Studies of the influence of smaller body type on the severity of prosthesis-patient mismatch (PPM) after small-sized surgical aortic valve replacement (SAVR) are few, but the issue is particularly relevant for Asian patients.Methods and Results: 695 patients who underwent SAVR with bioprosthetic valves had their hemodynamic valve performance analyzed at 3 months, 1 year, 3 years, and 5 years after operation, and clinical outcomes were assessed. The patients were stratified into 3 valve size groups: 19/21, 23, and 25/27 mm. A smaller valve was associated with higher mean pressure gradients at the 4 time points after operation (P trend <0.05). However, the 3 valve size groups demonstrated no significant differences in the risk of clinical events. At none of the time points did patients with projected PPM show increased mean pressure gradients (P>0.05), whereas patients with measured PPM did (P<0.05). Compared with patients with projected PPM, those with measured PPM demonstrated higher rates of infective endocarditis readmission (adjusted hazard ratio [aHR] 3.31, 95% confidence interval [CI] 1.06-10.39) and a higher risk of composite outcomes (aHR 1.45, 95% CI 0.95-2.22, P=0.087).

CONCLUSIONS: Relative to those receiving larger valves, patients receiving small bioprosthetic valves had poorer hemodynamic performance but did not demonstrate differences in clinical events in long-term follow-up.

原文英語
頁(從 - 到)559-567
頁數9
期刊Circulation Journal
88
發行號4
DOIs
出版狀態已出版 - 25 03 2024

文獻附註

Publisher Copyright:
© 2024 Japanese Circulation Society. All rights reserved.

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