Abstract

CASTRO, Edgardo D. et al. Comparison between Patient-Aortic Valve Prosthesis Mismatch Determined by Transthoracic Echo-Doppler at Late Follow-up versus Preoperative Estimation. Rev. argent. cardiol. [online]. 2008, vol.76, n.2, pp.106-111. ISSN 1850-3748.

Background Patient-aortic valve prosthesis mismatch (PPM) is associated with poor postoperative outcomes. Determination of aortic effective orifice area (EOA) indexed for body surface area (BSA) is useful to select suitable type and size of heart valve prosthesis in order to prevent patient-prosthesis mismatch. Objective The objective of this study was to compare the PPM estimated by indexed EOA with PPM determined by echo-Doppler at late follow-up. Material and Methods Fifty seven patients (43 men) who had undergone an aortic valve replacement in the previous 6 months were retrospectively assessed. After calculating BSA from the surgical report, indexed EOA, postoperative EOA (determined by the continuity equation with transthoracic echo-Doppler), preoperative and postoperative PPM were compared. An indexed EOA < 0.75 cm²/m² was considered aortic PPM. Results The prevalence of preoperative and postoperative PPM was 29.8% and 54.4%, respectively (p=0.029); 31% of MMP was severe. The prevalence of overweight in this sample was 80%. Conclusions In this group of patients with a high prevalence of overweight, the estimation of preoperative EOA indexed for BSA in order to predict postoperative PPM according to the type of prosthesis, showed significantly differences between preoperative PPM and postoperative PPM calculated by echo-Doppler. Further studies should not only include a larger sample, but should also check the method used for calculating valvular area (for example, in the left ventricular outflow tract).

Keywords : Aortic Valve; Echocardiography; Heart Valve Prosthesis.

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