Original articleAdult cardiacEffect of Prosthesis-Patient Mismatch on Long-Term Survival With Mitral Valve Replacement: Assessment to 15 Years
Section snippets
Patients and Methods
This is a retrospective study of prospectively collected data from the University of British Columbia Cardiac Valve Database. The database receives annual renewal from the University of British Columbia Clinical Research Ethics Board, which has a formal informed consenting process of patients.
From 1982 to 2002, 2,440 patients had MVRs at the affiliated teaching hospitals (St. Paul's Hospital, Vancouver General Hospital and Royal Columbian Hospital) of the University of British Columbia. There
Results
Of the total population of 2,440 patients, 345 (14.1%) had nonsignificant PPM, 1,696 (69.5%) had mild-to-moderate PPM, and 399 (16.4%) had severe PPM. The mean follow-up was 6.1 ± 4.6 years (median 5.9 years). During follow-up, 933 (38.2%) died: early mortality 159 (6.5%) (BP 8.6%, MP 3.9%; p ω 0.0001); late mortality 744 (31.7%); cardiac-related mortality 452 (18.5%); and valve-related mortality 168 (6.9%). The early mortality for nonsignificant-normal patients (PPM-A) was 5.5%,
Comment
This study identified the risk factors for mortality after MVR, considering specifically effective orifice area index categories. The significant findings of the study are related to the total lack of long-term survival influence to 12 to 15 years in all the modeling of mortality, inclusive of mild-to-moderate prosthesis-patient mismatch and severe prosthesis-patient mismatch. The interest in prosthesis-patient mismatch with valve replacement has only been documented since 2004 [15, 16, 17, 20
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