PMID: 20099694Jan 27, 2010Paper

How reliable is an effective orifice area indexed chart?

The Journal of Heart Valve Disease
Chad M HouseRanjan Dahiya

Abstract

Patient-prosthesis mismatch (PPM) occurs when a valvular prosthesis is too small relative to the patient's body surface area (BSA). The presence of PPM results in increased transprosthetic gradients and may portend a worse prognosis. It has been shown that reliable effective orifice area (EOA) data can be used to accurately predict PPM, thus preventing its occurrence. The study aim was to assess the predictive abilities of an effective orifice area indexed (EOAI) chart--the Perimount Magna EOAI chart--in the prevention of PPM. A retrospective comparison of projected versus calculated EOA values and the predicted versus actual incidence of PPM was conducted. Forty patients with a Perimount Magna aortic bioprosthesis implanted between 1st January 2006 and 31st March 2009, were identified. The sensitivity, specificity, positive-predictive value (PPV) and negative predictive value (NPV) were each calculated using the Perimount Magna EOAI chart, to assess how well it could predict the incidence of postoperative PPM. The Perimount Magna EOAI chart had a sensitivity of 35% for predicting postoperative PPM, and an NPV of 53%. The projected EOA-values were almost invariably larger than those actually measured; this resulted in a higher ...Continue Reading

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