Abstract:Since 1978 the definition of prosthesis-patient mismatch（PPM） was first introduced by Rahimtoola, it has attracted the attention of foreign researchers. The PPM phenomenon is concerned to be an important factor which will affect patients＇ survival rate and quality of life. Till now, a lot of effort should still be put on this problem. But unfortunately, this problem is still being neglected in our country. This paper is a review of PPM from it＇s many aspects, such as definition, current research status, prevention, and it＇s research prospect. We hope this paper will intensify the clinicians＇ knowledge on PPM.
Technical advances both in cardiac surgery and relating to anesthesia,cardiopulmonary bypass and myocardial protection have significantly improved the prognosis for patients combined with coronary heart disease and heart valve disease. In addition to technology, variable factors that affect operative survival following combined operation include the severity of valvular disease, the number of coronary vessels affected, impairment of left ventricular function and both age and gender differences. In this article, we review the outcome of surgical intervention for heart valve disease combined with coronary heart disease and discuss future prospects in this field.
Objective To compare and evaluate the short-term outcomes of 3 different tricuspid valve plasty for functional tricuspid regurgitation (TR) in patients with rheumatic heart disease. Methods Between October 2010 and June 2011, 148 patients with rheumatic heart disease undergoing left heart valve replacement and tricuspid valve plasty for functional TR were enrolled in the study. There were 32 males and 116 females with an average age of 47.5 years (range, 15-66 years). The patients were divided into 3 groups depending on tricuspid valve plasty: Cosgrove-Edwards annuloplasty ring group (annuloplasty ring group, 58 cases), Kay annuloplasty group (Kay group, 61 cases), and DeVega annuloplasty group (DeVaga group, 29 cases). There was no significant difference in general data among groups (P gt; 0.05), except more severe TR degree, higher atrial fibrillation, and higher radiofrequency ablation in annuloplasty ring group (P lt; 0.05). Perioperative data were recorded. The heart function was evaluated according to the standard of New York Heart Association (NYHA). Echocardiography (ECG) was used to record the TR class during perioperative period and follow-up. Results After operation, 1 case in Kay group and 1 case in annuloplasty ring group were dead because of low cardiac output syndrome. Pneumonia happened in 2 cases of Kay group and in 1 case of annuloplasty ring group; re-operation was performed in 1 case of annuloplasty ring group because of sternal dehiscence. There was no significant difference in perioperative complication among 3 groups (P=0.840). The TR degree was significantly improved at discharge when compared with preoperative degree in 3 groups (P lt; 0.001). A total of 146 patients were followed up 6-12 months (mean, 7.3 months). The NYHA grade of 3 groups at last follow-up was improved when compared with preoperative grade (P lt; 0.001), but no significant difference among 3 groups (χ2=0.120, P=0.942). The TR degree at last follow-up was all improved in 3 groups when compared with preoperative degree (P lt; 0.001); the improved efficiency showed significant difference among 3 groups (χ2=26.827, P=0.000), it was significantly better in annuloplasty ring group than in the other 2 groups (P lt; 0.001), but no significant difference between DeVega group and Kay group (Z=1.467, P=0.142). Conclusion The early improved efficiency of TR after Cosgrove-Edwards annuloplasty is superior to that of Kay annuloplasty and DeVega annuloplasty.