title: Prosthesis-patient mismatch - what cardiac anesthesiologists need to know?
abstract: Prosthesis-patient Mismatch (PPM) is not uncommon with an incidence reported up to 70% after aortic valve (AV) replacement. Severe forms of PPM are less common (up to 20%); PPM can lead to increased short- and long-term morbidity and mortality. It is important to discriminate PPM from other forms of prosthetic valve dysfunction. Sometimes, prosthetic valve degenerative disease may coexist with PPM. Echocardiography plays an important role in the prevention and diagnosis of PPM. Preemptive strategies to prevent PPM include insertion of newer generation prosthetic valves with better hemodynamic characteristics, stentless prosthesis, aortic root enlargement to insert a larger prosthesis, aortic homograft, and transcutaneous AV implantation. We present an illustrative case and review the literature on PPM pertinent to anesthesiologists.
authors.affiliation: Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Kathirvel
authors.initials: K
authors.lastname: Subramaniam
authors.affiliation: Board Certified Cardiac Anesthesiologist, Tabriz, Iran.
authors.forename: Soheyla
authors.initials: S
authors.lastname: Nazarnia
mesh_terms: D000072080:Anesthesiologists; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011475:Prosthesis Failure / Q000009:adverse effects*; D012086:Reoperation