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Review
. 2006 Aug;92(8):1022-9.
doi: 10.1136/hrt.2005.067363. Epub 2005 Oct 26.

Prosthesis-patient mismatch: definition, clinical impact, and prevention

P Pibarot  1 , J G Dumesnil
Affiliations
Free PMC article
Review

Prosthesis-patient mismatch: definition, clinical impact, and prevention

P Pibarot et al. Heart. 2006 Aug.
Free PMC article

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 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.

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Conflict of interest statement

Drs Pibarot and Dumesnil have received financial support from Medtronic, St Jude Medical, and Edwards Life Science to conduct some of the studies presented in this article. They are also consultants and are on the speakers' bureaus of St Jude Medical and Medtronic.

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