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Case Studies | Medical Surgical | India | Volume 12 Issue 9, September 2023
Does the Size Matter? A Retrospective Study of Patients following Aortic Valve Replacement
Dr. Prasad M. | Dr. Shivanraj | Dr. Nikhil Pj Theckumparampil [2]
Abstract: Purpose: Prosthesis - patient mismatch (PPM) occurs when the implanted prosthesis is too small compared to the patient?s body surface area (BSA). We analyzed an Aortic Valve Replacement (AVR) study population to investigate PPM prevalence and the importance of aortic valve size. Methods: We conducted a retrospective study of patients aged 18 years and above with isolated aortic valve pathology who underwent AVR with a mechanical prosthetic valve at our center between January 2018 and December 2022. Patients with combined valve pathology and other concomitant surgeries were excluded. EOAi was predicted by calculating patients? BSA and matching to the valve - specific EOAi calculator. Results: Of the 177 patients with isolated mechanical AVR included in this study, PPM was not observed in 106 patients, while 71 patients had moderate PPM. All valves with moderate PPM were single leaflets, and 71% had PPM. The patients? age and BSA were significantly associated with the valve size. Also, BSA was substantially lower in subjects having PPM (p = 0.025). Conclusions: PPM after aortic valve replacement is associated with higher post - operative morbidity and mortality. Despite more frequent PPM experienced by patients with single - leaflet mechanical valves, the clinical conditions of all patients in our study improved with no negative immediate post - operative outcomes. We propose confirming the EAOi chart before implanting single leaflet mechanical valves and a longer follow - up period for the patients? best interests.
Keywords: Aortic valve replacement, prosthesis - patient mismatch, effective orifice area, body surface area
Edition: Volume 12 Issue 9, September 2023,
Pages: 1783 - 1787