Prosthesis–Patient Mismatch After AVR Matters

PPM in aortic valve replacements is associated with decreased survival in a large database study.

Prosthesis–patient mismatch (PPM), a small surgical aortic valve orifice for a patient's size, has been associated inconsistently with mortality, and its significance remains controversial. In a retrospective analysis, investigators linked the Society of Thoracic Surgeons Adult Cardiac Surgery Database to Medicare and Medicaid data to identify 59,779 patients who underwent surgical aortic valve replacement for aortic stenosis between 2004 and 2014.

The effective orifice area (EOA) was derived from literature reports and divided by body surface area to determine PPM. Moderate PPM (0.65–0.85 cm²/m²) and severe PPM (≤0.65 cm²/m²) were observed in 54% and 11% of patients, respectively; 89% of patients with PPM had prostheses ≤23 mm in diameter. …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)