Author + information
- Received July 27, 1999
- Revision received March 27, 2000
- Accepted June 1, 2000
- Published online October 1, 2000.
- ↵*Reprint requests and correspondence: Dr. Jean G. Dumesnil, Quebec Heart Institute, Laval Hospital, 2725 Chemin Sainte-Foy, Sainte-Foy, Quebec, Canada G1V-4G5
Prosthesis–patient mismatch is present when the effective orifice area of the inserted prosthetic valve is less than that of a normal human valve. This is a frequent problem in patients undergoing aortic valve replacement, and its main hemodynamic consequence is the generation of high transvalvular gradients through normally functioning prosthetic valves. The purposes of this report are to present an update on the concept of aortic prosthesis–patient mismatch and to review the present knowledge with regard to its impact on hemodynamic status, functional capacity, morbidity and mortality. Also, we propose a simple approach for the prevention and clinical management of this phenomenon because it can be largely avoided if certain simple factors are taken into consideration before the operation.
☆ This work was supported in part by the Medical Research Council of Canada, Ottawa, Ontario; the Heart and Stroke Foundation of Quebec, Montreal, Quebec; and the Fonds pour la Recherche en Santé du Québec, Montreal, Quebec, Canada. Dr. Pibarot is a Research Scholar at the Heart and Stroke Foundation of Canada, Ottawa, Ontario, Canada.
- Received July 27, 1999.
- Revision received March 27, 2000.
- Accepted June 1, 2000.
- American College of Cardiology