The Prognostic Significance of Patient-Prosthesis Mismatch after Aortic Valve Replacement
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(Nardi Paolo) - Tor Vergata University Policlinic of Rome Cardiac Surgery Division
(Russo Marco) - Tor Vergata University Policlinic of Rome Cardiac Surgery Division
(Saitto Guglielmo) - Tor Vergata University Policlinic of Rome Cardiac Surgery Division
(Ruvolo Giovanni) - Tor Vergata University Policlinic of Rome Cardiac Surgery Division
Abstract
Patient-prosthesis mismatch (PPM) is a controversial issue in current clinical practice. PPM has been reported to have a negative impact on patients¡¯ prognosis after aortic valve replacement in several studies, showing increased all-cause and cardiac mortality. Moreover, a close relationship has recently been described between PPM and structural valve deterioration in biological prostheses. In patients at risk for PPM, several issues should be considered, and in the current era of cardiac surgery, preoperative planning should consider the different types of valves available and the various surgical techniques that can be used to prevent PPM. The present paper analyses the state of the art of the PPM issue.
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Aortic valve replacement, Patient-prosthesis mismatch, Prognostic significance
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Moderate PPM should be avoided in patients with certain conditions, such as depressed left ventricular function, severe left ventricular hypertrophy, age £¼70 years, an athletic lifestyle, and concomitant mild or moderate mitral regurgitation not addressed by surgery, as well as in elderly patients seeking an enhanced quality of life.