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Impact of prosthesis-patient mismatch on late outcomes after bioprosthetic mitral valve replacement for mitral regurgitation

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  • Artificial Valve
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Abstract

Negative impact of prosthesis-patient mismatch on long-term survival after valve replacement has been reported. However, the effect of prosthesis-patient mismatch after bioprosthetic mitral valve replacement has not yet been well examined. The purpose of this study was to investigate the effect of prosthesis-patient mismatch on late outcomes after bioprosthetic mitral valve replacement for mitral regurgitation. A total of 181 patients underwent bioprosthetic mitral valve replacement between April 2008 and December 2016. After excluding patients with mitral stenosis and those with incomplete data, 128 patients were included in the study. Postoperative transthoracic echocardiography was performed before discharge for all patients and the effective orifice area of bioprosthetic mitral valve was calculated using the formula: 220/pressure half-time, and the effective orifice area index was calculated by the formula: effective orifice area/body surface area. Prosthesis-patient mismatch was defined as a postoperative effective orifice area index ≤ 1.2 cm2/m2. The characteristics and outcomes were compared between the groups. There were 34 patients (26.6%) with prosthesis-patient mismatch and 94 patients (73.4%) without prosthesis-patient mismatch. There were no significant differences in the in-hospital mortality and morbidities. Multivariable analysis showed that prosthesis-patient mismatch was an independent predictor of late mortality (hazard ratio 3.38; 95% confidence interval 1.69–6.75; p = 0.001) and death from heart failure (hazard ratio 31.03, 95% confidence interval 4.49–214.40, p < 0.001). Prosthesis-patient mismatch at discharge after mitral valve replacement for mitral regurgitation was associated with long-term mortality and death from heart failure.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Author notes

  1. Yuichiro Kitada and Mamoru Arakawa have contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya-ku, Saitama-shi, Saitama, 330-8503, Japan

    Yuichiro Kitada, Mamoru Arakawa, Homare Okamura, Kei Akiyoshi, Daijiro Hori, Naoyuki Kimura & Atsushi Yamaguchi

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  1. Yuichiro Kitada
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  2. Mamoru Arakawa
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  3. Homare Okamura
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  4. Kei Akiyoshi
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  6. Naoyuki Kimura
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  7. Atsushi Yamaguchi
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Contributions

YK, KA and MA carried out the data correcting. YK wrote the manuscript with support from HO and DH. NK and AY supervised the project.

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Correspondence to Yuichiro Kitada or Homare Okamura.

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Kitada, Y., Arakawa, M., Okamura, H. et al. Impact of prosthesis-patient mismatch on late outcomes after bioprosthetic mitral valve replacement for mitral regurgitation. J Artif Organs 25, 132–139 (2022). https://doi.org/10.1007/s10047-021-01299-9

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  • DOI: https://doi.org/10.1007/s10047-021-01299-9

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