Prosthesis–patient mismatch after aortic valve replacement predominantly affects patients with preexisting left ventricular dysfunction: Effect on survival,

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Presentation transcript:

Prosthesis–patient mismatch after aortic valve replacement predominantly affects patients with preexisting left ventricular dysfunction: Effect on survival, freedom from heart failure, and left ventricular mass regression Marc Ruel, MD, MPH, Hussam Al-Faleh, MD, Alexander Kulik, MD, Kwan L. Chan, MD, Thierry G. Mesana, MD, PhD, Ian G. Burwash, MD The Journal of Thoracic and Cardiovascular Surgery Volume 131, Issue 5, Pages 1036-1044 (May 2006) DOI: 10.1016/j.jtcvs.2005.10.028 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Crude (A) and adjusted (B) survival after aortic valve replacement, by left ventricular function and prosthesis–patient mismatch. Patients with the combination of impaired preoperative left ventricular function and postoperative prosthesis–patient mismatch had lower survival after aortic valve replacement, despite adjustment for age, other risk factors for mortality after AVR,2 and baseline patient characteristics. *Crude and adjusted hazard ratios are in comparison to the “Normal LV; No PPM” group. CI, Confidence interval; HR, hazard ratio; LV, left ventricle; PPM, prosthesis–patient mismatch. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1036-1044DOI: (10.1016/j.jtcvs.2005.10.028) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Effect of preoperative left ventricular function and prosthesis–patient mismatch on the cumulative incidence of heart failure symptoms or death related to heart failure at 3 years after aortic valve replacement. Nonitalic percentages, bars, and odds ratios refer to the occurrence of either heart failure symptoms or death. Italic percentages in parentheses indicate heart failure death. Odds ratios are in comparison to the “Normal LV; No PPM” group and are adjusted for risk factors of decreased freedom from heart failure after AVR2 and for baseline patient characteristics. Patients with the combination of impaired preoperative left ventricular function and postoperative prosthesis–patient mismatch had a lower freedom from heart failure despite adjustment for confounding factors. CI, Confidence interval; LV, left ventricle; PPM, prosthesis–patient mismatch. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1036-1044DOI: (10.1016/j.jtcvs.2005.10.028) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions