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Prosthesis-patient mismatch: definition, clinical impact, and prevention Pibarot P; Dumesnil JGHeart 2006[Aug]; 92 (8): 1022-9Prosthesis-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.|*Heart Valve Prosthesis[MESH]|Aortic Valve/*surgery[MESH]|Blood Loss, Surgical[MESH]|Heart Valve Diseases/mortality/*surgery[MESH]|Heart Valve Prosthesis Implantation[MESH]|Humans[MESH]|Postoperative Complications/etiology/mortality[MESH]|Prosthesis Design[MESH]|Prosthesis Fitting[MESH]|Risk Factors[MESH]|Treatment Outcome[MESH]|Ventricular Dysfunction, Left/etiology[MESH] |
