Impact of prosthesis-patient size on functional recovery after aortic valve replacement

Prosthesis-patient size mismatch results when an implanted prosthetic aortic valve is of insufficient size for a patient's body surface area. The relation between prosthesis-patient size and functional capacity and adverse postoperative outcome is inconsistent. Our objectives were to examine th...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2005-06, Vol.111 (24), p.3221-3229
Main Authors: KOCH, Colleen Gorman, KHANDWALA, Farah, ESTAFANOUS, Fawzy G, LOOP, Floyd D, BLACKSTONE, Eugene H
Format: Article
Language:English
Subjects:
Adult
Animals
Aortic Valve - surgery
Aortic Valve Insufficiency - mortality
Aortic Valve Insufficiency - surgery
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Data Collection
Diseases of the aorta
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
Follow-Up Studies
Heart Valve Prosthesis - standards
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - methods
Heart Valve Prosthesis Implantation - mortality
Humans
Logistic Models
Male
Medical sciences
Middle Aged
Orthopedic surgery
Prosthesis Design
Quality of Life
Risk Factors
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Treatment Outcome
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Summary:Prosthesis-patient size mismatch results when an implanted prosthetic aortic valve is of insufficient size for a patient's body surface area. The relation between prosthesis-patient size and functional capacity and adverse postoperative outcome is inconsistent. Our objectives were to examine the impact of valve replacement, continuous prosthesis-patient size, and other factors on functional recovery after aortic valve replacement (AVR) with the Duke Activity Status Index (DASI). From June 15, 1995, through May 14, 1998, 1108 patients underwent AVR after completing a DASI survey. Of these, 1014 completed a postoperative DASI survey at an average of 8.3 months postoperatively. Logistic ordinal regression was used to examine the influence of demographic variables, comorbidities, baseline DASI scores, indexed valve orifice area, standardized orifice size, and postoperative morbid events on postoperative DASI. There was overall improvement in postoperative functional recovery reflected by median preoperative and postoperative DASI scores of 29 and 46, P
ISSN:0009-7322
1524-4539
DOI:10.1161/circulationaha.104.505248