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Impact of prosthesis-patient mismatch on survival after mitral valve replacement: a systematic review

摘要Objective To determine whether the prosthesis-patient mismatch has a deleterious impact on survival after mitral valve replacement.Data sources A comprehensive literature search of PubMed,Embase,and ScienceDirect was carried out.References and cited papers of relevant articles were also checked.Study selection All articles published after January 1980 was initially considered.Non-English and non-human studies,case reports,and reviews were excluded from the initial search.References and cited papers of relevant articles were also checked.Results A total of 8 retrospective cohort studies were identified for this review.The overall incidence of prosthesis-patient mismatch (<1.3 to <1.2 cm2/m2) after mitral valve replacement ranged from 3.7% to 85.9% (moderate prosthesis-patient mismatch (0.9 to 1.2 cm2/m2) in 37.4% to 69.5%,severe prosthesis-patient mismatch (<0.9 cm2/m2) in 8.7% to 16.4%).Four studies demonstrated an association of prosthesis-patient mismatch with reduced long-term survival,but the other four studies found no significant deleterious impact of prosthesis-patient mismatch after mitral valve replacement.No definite conclusion could be derived from these conflicting results.Conclusions Current evidence is insufficient to derive a definite conclusion whether mitral prosthesis-patient mismatch affects long-term survival because of the biases and confounding factors that interfere with late clinical outcomes.Good-quality prospective studies are warranted to evaluate the impact of mitral prosthesis-patient mismatch after mitral valve replacement in the future.

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作者单位 Department of Cardiac Surgery , Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China [1] Department of Cardiac Surgery ,Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China [2] Department of Cardiology , Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China [3]
栏目名称 REVIEW ARTICLES
DOI 10.3760/cma.j.issn.0366-6999.20131462
发布时间 2013-11-12
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中华医学杂志(英文版)

中华医学杂志(英文版)

2013年126卷19期

3762-3766页

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