Interaction and prognostic effects of @entity1002 and XXXX -prosthesis mismatch as determinants of outcome after isolated aortic valve replacement.

@entity1 @entity1283 @entity67 @entity204 @entity1002
There are variable reported effects of @entity1 -prosthesis mismatch (P-PM) on outcome. It was hypothesized that the adverse effect attributed to P-PM is actually due to @entity1002 ( @entity67 ) in @entity1 with small hearts. The aim of this study was therefore to determine the association among P-PM, @entity67 , and outcomes. Doppler echocardiography was performed in 156 @entity1 after aortic valve replacement. In vivo effective orifice areas for each prosthesis type and size were obtained from published references values of normally functioning prostheses. P-PM was identified from the predicted indexed orifice area, obtained by dividing the effective orifice area by body surface area. @entity67 was classed as normal, delayed relaxation (prolonged deceleration time for age), or increased left atrial pressure (increased E/E' ratio, left @entity1283 , short deceleration time). Events (cardiac-related hospitalizations and all-cause mortality after aortic valve replacement) were determined over a median follow-up periods of 3.5 years (interquartile range 2.1 to 5.7). P-PM was found in 91 @entity1 (58%). Of the @entity1 with P-PM, no @entity67 was present on postoperative echocardiography in 15 @entity1 (16%), delayed relaxation in 35 (39%), and increased left atrial pressure in 41 (45%). There were 61 total events (18 @entity204 and 43 hospitalizations): 4 (7%) in the no- @entity67 group, 26 (42%) in the delayed relaxation group, and 31 (51%) in the increased left atrial pressure group. @entity67 (p = 0.034) but not age (p = 0.09), the left ventricular ejection fraction (p = 0.60), or the presence of mismatch (p = 0.20) was associated with events. In conclusion, P-PM was associated with 14% mortality and a 39% composite event rate over 2-year follow-up. Events were significantly associated with @entity67 .
