title: Prosthesis-patient mismatch in aortic stenosis.
abstract: BACKGROUND
  The clinical impacts of prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR) have been debated since Rahimtoola first reported PPM in 1978. Many reports discussing several aspects of PPM have been published to date, but the definitive clinical impacts of PPM have not yet been clarified.
  
  
  OBJECTIVE
  The purpose of this review is to evaluate recent articles regarding PPM and discuss the latest findings.
  
  
  RESULTS
  Moderate PPM (indexed effective orifice area ≤ 0.85 cm(2)/m(2)) did not affect the surgical outcomes in several papers, but severe PPM (indexed effective orifice area ≤ 0.65 cm(2)/m(2)) affected early and late mortality in almost of the all papers in which it was reported. PPM had a greater effect on younger patients and patients with left ventricular dysfunction than it did on elderly patients and patients with preserved left ventricular function.
  
  
  CONCLUSIONS
  Based on recent findings, it is difficult to define the impact of PPM after AVR. To some degree, PPM affects the clinical outcomes after AVR; therefore, it is important to avoid PPM, especially severe PPM.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-0012, Japan, honda-k@wakayama-med.ac.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Honda
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Okamura
mesh_terms: D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D013318:Stroke Volume; D016277:Ventricular Function, Left