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Ann Thorac Surg 2008;85:1317-1318. doi:10.1016/j.athoracsur.2008.02.002
© 2008 The Society of Thoracic Surgeons
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Original Articles: Adult Cardiac

Invited Commentary

Vivek Rao, MD, PhD

Peter Munk Cardiac Center, University Health Network, University of Toronto, 4N-464, Toronto General Hospital, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4

(Email: vivek.rao@uhn.on.ca).

The first 20% of the full text of this article appears below.

The concept of prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR) remains controversial today as long-term follow-up studies with adequate power to detect survival differences continue to provide discordant results [1–5]. Our previous study in 2000 demonstrated impaired survival after 7 years in patients who had PPM defined as an indexed effective orifice area (EOA) of < 0.85 cm2/m2 [1]. Due to the fact that we used the manufacturer’s reported "in-vitro" EOA, we liberalized our definition of PPM compared with the 0.75 cm2/m2 defined by Rahimtoola’s [4] original description.

Similarly, Pibarot and colleagues [3] reported adverse hemodynamic effects of PPM in 392 patients undergoing stented AVR. Pibarot and colleagues’ [3] study revealed no survival differences, but important adverse effects of PPM on postoperative hemodynamics and symptom status. Subsequent studies by Pibarot and colleagues’ examined patients subjected to exercise . . . [Full Text of this Article]


Related Article

Influence of Prosthesis–Patient Mismatch on Diastolic Heart Failure After Aortic Valve Replacement
Shahab Nozohoor, Johan Nilsson, Carsten Lührs, Anders Roijer, and Johan Sjögren
Ann. Thorac. Surg. 2008 85: 1310-1317. [Abstract] [Full Text] [PDF]





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