Background: Prosthesisââ?¬â??patient mismatch (PPM) may affect the clinical outcomes of patients undergoing aortic\nvalve replacement (AVR). We aimed to determine the incidence of PPM, its effect on short-term mortality, and the\nfactors contributing to PPM in China.\nMethods: We retrospectively examined all consecutive patients with isolated or concomitant AVR at our hospital\nbetween January 1, 2013 and December 31, 2015. PPM was defined as an effective orifice area index (EOAi) of ââ?°Â¤ 0.\n85 cm2/m2. The baseline, echocardiographic, operative, and outcome data of all patients were collected from the\nnational database.\nResults: A total of 869 patients were included in the study. PPM was detected in 15.9% (138/869) of the patients. Four\npatients (0.5%) met the criteria for severe PPM. Patients with PPM were older and had a higher prevalence of diabetes,\ncoronary heart disease, aortic stenosis (AS), and preoperative left ventricular dysfunction but a lower incidence of smoking\nhistory and aortic regurgitation. Logistic regression analysis showed that female gender (P < 0.001), AS (P= 0.014), higher\nbody mass index (BMI) (P < 0.001), and bioprosthesis (P < 0.001) were independent predictors of PPM. We also found that\nPPM (P = 0.005) was associated with 30-day all-cause mortality, along with smoking history (P= 0.001) and low\npreoperative left ventricular ejection fraction (LVEF) (P= 0.004).\nConclusions: PPM is associated with high short-term mortality after AVR in China. Female gender, aortic stenosis,\nbioprosthesis, and high BMI are risk factors for the incidence of PPM.
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