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Prosthesis-patient mismatch negatively affects outcomes after mitral valve replacement: meta-analysis of 10, 239 patients
Sá, Michel Pompeu Barros Oliveira; Cavalcanti, Luiz Rafael Pereira; Rayol, Sérgio da Costa; Diniz, Roberto Gouvea Silva; Menezes, Alexandre Motta; Clavel, Marie-Annick; Pibarot, Philippe; Lima, Ricardo Carvalho.
Afiliação
  • Sá, Michel Pompeu Barros Oliveira; Pronto Socorro Cardiológico de Pernambuco. Department of Cardiovascular Surgery. Recife. BR
  • Cavalcanti, Luiz Rafael Pereira; Pronto Socorro Cardiológico de Pernambuco. Department of Cardiovascular Surgery. Recife. BR
  • Rayol, Sérgio da Costa; Pronto Socorro Cardiológico de Pernambuco. Department of Cardiovascular Surgery. Recife. BR
  • Diniz, Roberto Gouvea Silva; Pronto Socorro Cardiológico de Pernambuco. Department of Cardiovascular Surgery. Recife. BR
  • Menezes, Alexandre Motta; Pronto Socorro Cardiológico de Pernambuco. Department of Cardiovascular Surgery. Recife. BR
  • Clavel, Marie-Annick; Institut Universitaire de Cardiologie et de Pneumologie du Québec. CA
  • Pibarot, Philippe; Institut Universitaire de Cardiologie et de Pneumologie du Québec. CA
  • Lima, Ricardo Carvalho; Pronto Socorro Cardiológico de Pernambuco. Department of Cardiovascular Surgery. Recife. BR
Rev. bras. cir. cardiovasc ; 34(2): 203-212, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-990564
Biblioteca responsável: BR1.1
ABSTRACT
Abstract

Objective:

This study sought to evaluate the impact of prosthesis-patient mismatch on the risk of perioperative and long-term mortality after mitral valve replacement.

Methods:

Databases were researched for studies published until December 2018. Main outcomes of interest were perioperative and 10-year mortality and echocardiographic parameters.

Results:

The research yielded 2,985 studies for inclusion. Of these, 16 articles were analyzed, and their data extracted. The total number of patients included was 10,239, who underwent mitral valve replacement. The incidence of prosthesis-patient mismatch after mitral valve replacement was 53.7% (5,499 with prosthesis-patient mismatch and 4,740 without prosthesis-patient mismatch). Perioperative (OR 1.519; 95%CI 1.194-1.931, P<0.001) and 10-year (OR 1.515; 95%CI 1.280-1.795, P<0.001) mortality was increased in patients with prosthesis-patient mismatch. Patients with prosthesis-patient mismatch after mitral valve replacement had higher systolic pulmonary artery pressure and transprosthethic gradient and lower indexed effective orifice area and left ventricle ejection fraction.

Conclusion:

Prosthesis-patient mismatch increases perioperative and long-term mortality. Prosthesis-patient mismatch is also associated with pulmonary hypertension and depressed left ventricle systolic function. The findings of this study support the implementation of surgical strategies to prevent prosthesis-patient mismatch in order to decrease mortality rates.
Assuntos


Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Falha de Prótese / Próteses Valvulares Cardíacas / Implante de Prótese de Valva Cardíaca / Valva Mitral Tipo de estudo: Estudo de etiologia / Fatores de risco / Revisão sistemática Limite: Feminino / Humanos / Masculino Idioma: Inglês Revista: Rev. bras. cir. cardiovasc Assunto da revista: Cardiologia / CIRURGIA GERAL Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Brasil / Canadá Instituição/País de afiliação: Institut Universitaire de Cardiologie et de Pneumologie du Québec/CA / Pronto Socorro Cardiológico de Pernambuco/BR

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Falha de Prótese / Próteses Valvulares Cardíacas / Implante de Prótese de Valva Cardíaca / Valva Mitral Tipo de estudo: Estudo de etiologia / Fatores de risco / Revisão sistemática Limite: Feminino / Humanos / Masculino Idioma: Inglês Revista: Rev. bras. cir. cardiovasc Assunto da revista: Cardiologia / CIRURGIA GERAL Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Brasil / Canadá Instituição/País de afiliação: Institut Universitaire de Cardiologie et de Pneumologie du Québec/CA / Pronto Socorro Cardiológico de Pernambuco/BR
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