title: Prosthesis-patient mismatch: an update.
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.
authors.affiliation: Quebec Heart and Lung Institute, 2725 Chemin Sainte-Foy, Québec, Quebec, Canada G1V-4G5. jean.dumesnil@med.ulaval.ca
authors.forename: Jean G
authors.initials: JG
authors.lastname: Dumesnil
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
mesh_terms: D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality / Q000592:standards; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D019300:Medical Errors / Q000009:adverse effects / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D017755:Prosthesis Fitting / Q000379:methods; D016896:Treatment Outcome