The effect of fat free mass index and other predictive factors on the severity of patient prosthesis mismatch in patients with isolated mechanical aortic valve replacement

Aims: The development of patient prosthesis mismatch (PPM) in patients undergoing aortic valve replacement (AVR) is an important problem in terms of functional capacity and cardiac events in the postoperative period. Increasing the severity of PPM will increase the transvalvular gradient and retard cardiac recovery. The aim of this study was to determine the relationship between PPM severity and fat free mass index (FFMI) and other predictive factors in patients who underwent AVR. Methods: A total of 73 patients, who underwent isolated mechanical aortic valve replacement between September-2017 and February-2020 and developed PPM in the postoperative period, were included in the study. Preoperative data, operation data, and postoperative follow-up of the included cases were reviewed. Body surface area (BSA) and body mass index (BMI) were calculated using the height and weight measurements of the patients. Echocardiography (ECHO) examinations of the cases were evaluated preoperatively and at the first, sixth and twelfth months after surgery. preoperative body fat ratios were measured using the bioimpedance method and FFMIs were calculated. According to the severity of PPM, patients were divided into 3 groups as mild, moderate, and severe. FFMI and other predictive factors were analyzed by comparing 3 groups among themselves Results: The effects of preoperative diagnosis, age, gender, BMI, FFMI, aortic cross clamp (ACC), cardiopulmonary bypass (CPB) duration on PPM severity were evaluated statistically and no significant effect was observed. It was determined that the size of the prosthetic valve implanted in the patient was closely related to the severity of PPM. Conclusion: It was seen that the size of the prosthesis to be selected was the most important parameter in terms of PPM severity. Severe PPM has been shown to have a worse prognosis than moderate and mild PPM in many studies. Reducing the severity of PPM may reduce the need for reoperation and the number of cardiac events that may occur. More extensive studies are needed to identify predictive factors associated with PPM severity. In this study, no statistically significant effect of fat free mass index on the severity of patient prosthesis mismatch in patients with isolated mechanical aortic valve replacement was detected