Browsing by Author "Lazovic, Jelena Milin (6507693272)"

Background: Patient-prosthesis mismatch (PPM) may impair functional capacity and survival after aortic valve replacement. This study aimed to investigate the impact of PPM on long-term survival and quality of life after mechanical and biological aortic valve replacement. Methods: This study included 595 consecutive patients who had undergone isolated aortic valve replace-ment. Patients were divided into 2 groups according to prosthesis type. The baseline and operative charac-teristics, survival rates, complications, and quality of life of the groups with and without PPM were compared for up to 6 years. The PPM calculation was performed using the effective orifice area value provided by the manufacturer divided by the patient’s body surface area. Results: The moderate to severe PPM rates were 69.8% and 3.7% after biological and mechanical prosthesis implantation, respectively. Mean survival for patients in the biological group who had PPM was statistically significantly shorter (50.2 months [95% CI, 45.2-55.3]) than for patients in the biological group without PPM (60.1 months [95% CI, 55.7-64.4]; P = .04). In the mechanical prosthesis group, there was no difference in mean survival between the subgroup with PPM (66.6 months [95% CI, 58.3-74.9]) and the subgroup without PPM (64.9 months [95% CI, 62.6-67.2]; P = .50). A quality-of-life questionnaire’s scores did not differ between the groups. Conclusion: Mismatch is common after biological valve implantation and statistically significantly affects long-term survival and quality of life. If the risk of PPM after implantation of a biological prosthesis is sus-pected, adopting strategies to avoid PPM at the time of surgery is warranted. © 2023, Texas Heart Institute. All rights reserved.

Objective: To assess torsion outcomes and evaluates the rate of testicular atrophy. Methods: The study was done over the 2000-2024 period during which 103 patients of average age 12.9 ± 3.0 were echosonographically followed up after operative detorquation and testicular salvage. The study included three groups based on the timing of intervention: Group 1 “<6 hours,” Group 2 “6-12 hours,” and Group 3 “>12 hours.” The median follow-up for all groups was 65 (60-84) months. Results: The presence of a detorsed testis was significantly higher in the Group 1 where all cases had existing testis, compared to 64.7% in the Group 2 and only 20.8% in the Group 3 (P <.001). The detorsed testis volume was significantly larger in the Group 1 compared to the Group 2 and the Group 3 (P <.001 for both comparisons). The analysis of blood flow through the testis revealed significant differences between the groups (P <.001). The structure homogenousness was present in 20 (55.6%) patients in the Group 1, and non-existent in all the patients in the Group 2 and the Group 3, (P <.001). Conclusion: The risk of testicular atrophy after many years of follow-up is significantly higher compared to the current literature. Testicular salvage is not possible if more than 6 hours have passed since the onset of symptoms. The high incidence of heterogeneous presentation on ultrasound of salvaged testes, which did not show signs of atrophy, raises the question of the possible harmful impact of salvaged testes on male fertility. © 2025 Elsevier Inc.