{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T10:49:36Z","timestamp":1792234176561,"version":"4.4.0"},"reference-count":101,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,4,2]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">It remains controversial whether prosthesis\u2010patient mismatch (PPM) impacts long\u2010term outcomes after surgical aortic valve replacement. We aimed to evaluate the association of PPM with mortality, rehospitalizations, and aortic valve reinterventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We performed a systematic review with meta\u2010analysis of reconstructed time\u2010to\u2010event data of studies published by March 2023 (according to the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses). Sixty\u2010five studies met our eligibility criteria and included 122\u2009989 patients (any PPM: 68 332 patients, 55.6%). At 25\u2009years of follow\u2010up, the survival rates were 11.8% and 20.6% in patients with and without any PPM, respectively (hazard ratio [HR], 1.16 [95% CI, 1.13\u20131.18],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). At 20\u2009years of follow\u2010up, the survival rates were 19.5%, 12.1%, and 8.8% in patients with no, moderate, and severe PPM, respectively (moderate versus no PPM: HR, 1.09 [95% CI, 1.06\u20131.11],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001; severe versus no PPM: HR, 1.29 [95% CI, 1.24\u20131.35],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). PPM was associated with higher risk of cardiac death, heart failure\u2013related hospitalizations, and aortic valve reinterventions over time (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Statistically significant associations between PPM and worse survival were observed regardless of valve type (bioprosthetic versus mechanical valves), contemporary PPM definitions unadjusted and adjusted for body mass index, and PPM quantification method (in vitro, in\u00a0vivo, Doppler echocardiography). Our meta\u2010regression analysis revealed that populations with more women tend to have higher HRs for all\u2010cause death associated with PPM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The results of the present study suggest that any degree of PPM is associated with poorer long\u2010term outcomes following surgical aortic valve replacement and provide support for implementation of preventive strategies to avoid PPM after surgical aortic valve replacement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.033176","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T08:03:23Z","timestamp":1711526603000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":76,"title":["Impact of Prosthesis\u2010Patient Mismatch 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