Influence of Patient-Prosthesis Mismatch on Long-Term Results after Aortic Valve Replacement with a Stented Bioprosthesis
Jean M. Frapier MD, Philippe Rouvière MD, Franck Razcka MD, Thierry Aymard MD, Bernard Albat MD, Paul A. Chaptal MD

The study aim was to evaluate the long-term effect of patient-prosthesis mismatch (effective orifice area/body surface area £0.85 cm2/m2) in a population of 90 consecutive patients who received an aortic Medtronic Intact valve either with (n = 64) or without (n = 26) mismatch. At 10 years postoperatively there was no significant inter-group difference in overall survival. By multivariate analysis, the main risk factor for late death was a left ventricular ejection fraction (LVEF) <50% (p = 0.0001). Freedom from cardiac death was not significantly different when LVEFs were paired between two groups. The NYHA functional status of survivors showed 94.4% of mismatch patients and 100% of no-mismatch patients to be in NYHA classes I and II (p = 1). Within this population, it was not possible to demonstrate negative effects of mismatch at 10 years after Intact bioprosthetic aortic valve replacement, and LVEF was the only predictor for late death.