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Prosthesis-Patient Mismatch Negatively Affects Outcomes after Mitral Valve Replacement: Meta-Analysis of 10,239 Patients

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Main Author:	Michel Pompeu Barros Oliveira Sá
Format:	Artículo científico
Language:	en
Published:	Sociedade Brasileira de Cirurgia Cardiovascular 2019
Subjects:	Medicina Meta Surgery Analysis Prosthesis Mitral Valve
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_version_	1876443319819567104
author	Michel Pompeu Barros Oliveira Sá
author_facet	Michel Pompeu Barros Oliveira Sá
contents	Prosthesis-Patient Mismatch Negatively Affects Outcomes after Mitral Valve Replacement: Meta-Analysis of 10,239 Patients Michel Pompeu Barros Oliveira Sá Luiz Rafael Pereira Cavalcanti Sérgio da Costa Rayol Roberto Gouvea Silva Diniz Alexandre Motta Menezes Marie-Annick Clavel Philippe Pibarot Ricardo Carvalho Lima Medicina Meta Surgery Analysis Prosthesis Mitral Valve Objective: This study sought to evaluate the impact of prosthesis-patient mismatch on the risk of perioperative and longterm 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 prosthesispatient 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 prosthesispatient mismatch in order to decrease mortality rates. 2019 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398959097014 https://www.redalyc.org/journal/3989/398959097014/ https://www.redalyc.org/journal/3989/398959097014/html/ https://www.redalyc.org/journal/3989/398959097014/398959097014.epub https://www.redalyc.org/journal/3989/398959097014/movil 10.21470/1678-9741-2019-0069 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.2 Vol.34
format	Artículo científico
id	redalyc_398959097014
institution	Redalyc
language	en
publishDate	2019
publisher	Sociedade Brasileira de Cirurgia Cardiovascular
spellingShingle	Prosthesis-Patient Mismatch Negatively Affects Outcomes after Mitral Valve Replacement: Meta-Analysis of 10,239 Patients Michel Pompeu Barros Oliveira Sá Medicina Meta Surgery Analysis Prosthesis Mitral Valve Prosthesis-Patient Mismatch Negatively Affects Outcomes after Mitral Valve Replacement: Meta-Analysis of 10,239 Patients Michel Pompeu Barros Oliveira Sá Luiz Rafael Pereira Cavalcanti Sérgio da Costa Rayol Roberto Gouvea Silva Diniz Alexandre Motta Menezes Marie-Annick Clavel Philippe Pibarot Ricardo Carvalho Lima Medicina Meta Surgery Analysis Prosthesis Mitral Valve Objective: This study sought to evaluate the impact of prosthesis-patient mismatch on the risk of perioperative and longterm 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 prosthesispatient 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 prosthesispatient mismatch in order to decrease mortality rates. 2019 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398959097014 https://www.redalyc.org/journal/3989/398959097014/ https://www.redalyc.org/journal/3989/398959097014/html/ https://www.redalyc.org/journal/3989/398959097014/398959097014.epub https://www.redalyc.org/journal/3989/398959097014/movil 10.21470/1678-9741-2019-0069 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.2 Vol.34
title	Prosthesis-Patient Mismatch Negatively Affects Outcomes after Mitral Valve Replacement: Meta-Analysis of 10,239 Patients
topic	Medicina Meta Surgery Analysis Prosthesis Mitral Valve
url	https://www.redalyc.org/articulo.oa?id=398959097014 https://www.redalyc.org/journal/3989/398959097014/ https://www.redalyc.org/journal/3989/398959097014/html/ https://www.redalyc.org/journal/3989/398959097014/398959097014.epub https://www.redalyc.org/journal/3989/398959097014/movil