Prosthesis-patient mismatch: definition, clinical impact, and prevention
- PMID: 16251232
- PMCID: PMC1861088
- DOI: 10.1136/hrt.2005.067363
Prosthesis-patient mismatch: definition, clinical impact, and prevention
Abstract
Prosthesis-patient mismatch (PPM) is present when the effective orifice area of the inserted prosthetic valve is too small in relation to body size. Its main haemodynamic consequence is to generate higher than expected gradients through normally functioning prosthetic valves. This review updates the present knowledge about the impact of PPM on clinical outcomes. PPM is common (20-70% of aortic valve replacements) and has been shown to be associated with worse haemodynamic function, less regression of left ventricular hypertrophy, more cardiac events, and lower survival. Moreover, as opposed to most other risk factors, PPM can largely be prevented by using a prospective strategy at the time of operation.
Conflict of interest statement
Drs Pibarot and Dumesnil have received financial support from Medtronic, St Jude Medical, and Edwards Life Science to conduct some of the studies presented in this article. They are also consultants and are on the speakers' bureaus of St Jude Medical and Medtronic.
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References
-
- Rahimtoola S H. The problem of valve prosthesis‐patient mismatch. Circulation 19785820–24. - PubMed
-
- Dumesnil J G, Yoganathan A P. Valve prosthesis hemodynamics and the problem of high transprosthetic pressure gradients. Eur J Cardiothorac Surg 19926S34–S38. - PubMed
-
- Pibarot P, Dumesnil J G. Patient‐prosthesis mismatch and the predictive use of indexed effective orifice area: is it relevant? Card Surg Today 2003143–51.
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