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Prosthesis-Patient Mismatch: An Update

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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 hemodynamic consequence is to generate higher than expected gradients through normally functioning prosthetic valves. The purpose of this review is to present an update on the present state of knowledge with regard to diagnosis, prognosis, and prevention of PPM. PPM is a frequent occurrence (20% to 70% of aortic valve replacements) that has been shown to be associated with worse hemodynamics, 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.

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Acknowledgments

This study was supported in part by Canadian Institutes of Health Research grants (MOP-10929, MOP-57745, MOP-67123, and MOP-86666). P. Pibarot is the holder of the Canada Research Chair in Valvular Heart Disease, Canadian Institutes of Health Research, Ottawa, Canada.

Disclosure

Conflicts of interest: J.G. Dumesnil: none; P. Pibarot: has received speakers’ honoraria from Sorin Medical and Edwards Lifesciences and has received research grants from Medtronic.

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  1. Quebec Heart and Lung Institute, 2725 Chemin Sainte-Foy, Québec, Quebec, Canada, G1V-4G5

    Jean G. Dumesnil & Philippe Pibarot

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  1. Jean G. Dumesnil
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  2. Philippe Pibarot
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Correspondence to Jean G. Dumesnil.

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Dumesnil, J.G., Pibarot, P. Prosthesis-Patient Mismatch: An Update. Curr Cardiol Rep 13, 250–257 (2011). https://doi.org/10.1007/s11886-011-0172-7

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