Abstract
| Patient number | Patient number | Patient number | Patient number | |
| 1 | 2 | 3 | 4 | 5 |
| Body surface area (m 2) | 1.5 | 1.75 | 2.0 | 2.25 |
| Cardiac output (l/min) | 4.5 | 5.25 | 6.0 | 6.75 |
| Valve EOA (cm 2) | 1.3 | 1.3 | 1.3 | 1.3 |
Full Answer
What is prosthesis patient mismatch?
5 rows · Oct 26, 2005 · Option 2: enlarge the aortic root to accommodate a larger prosthesis of the same type. Option 3: ...
Does prosthesis-patient mismatch affect survival in patients undergoing bioprosthetic aortic valve replacement?
Patient-prosthesis mismatch (PPM) occurs when an implanted prosthetic valve is too small for the patient; severe PPM is defined as an indexed effective orifice area (iEOA) <0.65 cm 2 /m 2 following aortic valve replacement (AVR). This review examines articles from the past 10 years addressing the prevalence, outcomes and options for prevention and treatment of PPM after …
What is the best mechanical prosthesis for aorta repair?
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 ...
Is patient‐prosthesis size a major risk factor for adverse clinical outcomes?
May 24, 2018 · In patients with small aortic annulus, surgeons sometimes resort to aortic root widening procedures to accommodate larger sized prosthetic valves to avoid mismatch. But these procedures require extra skill and increases the surgical time and hence the possible periprocedural morbidity.
What is PPM in surgery?
PPM may be a marker of comorbidity rather than a risk factor for adverse outcomes.
Is PPM a risk factor?
PPM may be a marker of comorbidity rather than a risk factor for adverse outcomes. PPM should be suspected in patients with persistent cardiac symptoms after AVR when there is high prosthetic valve velocity or gradient and a small calculated effective orifice area.
Is PPM a risk factor?
PPM is a common and modifiable risk factor leading to worse haemodynamic function, less regression of LV hypertrophy, more cardiac events, and lower survival. The projected indexed EOA should be systematically calculated at the time of the operation to estimate the risk of PPM and, if PPM is anticipated, alternative options should be considered in light of the patient’s overall clinical condition and risk to benefit ratio.
What is Table 2 of PPM?
Table 2 summarises the impact of PPM on clinical outcomes. As indicated above, the studies based on the indexed IGA are not really descriptive of PPM. They are given in the interest of completeness and to dispel any confusion but will not be described in any further detail.
Abstract
Patient-prosthesis mismatch (PPM) occurs when an implanted prosthetic valve is too small for the patient; severe PPM is defined as an indexed effective orifice area (iEOA) <0.65 cm 2 /m 2 following aortic valve replacement (AVR).
Definition and prevalence
Based on observational clinical studies, the most common definition of severe PPM is an indexed effective orifice area (iEOA) <0.65 cm 2 /m 2 with moderate PPM defined as an EOA between 0.65 and 0.85 cm 2 /m 2.
Diagnosis
Echocardiography is recommended early after AVR to provide baseline valve haemodynamics at a time when valve deterioration has not yet occurred.
Clinical outcomes
It remains controversial whether PPM is associated with a higher rate of adverse outcomes early after AVR ( table 2 ), 11–21 with recent studies showing no significant difference in complications between those with and without PPM.
Prevention of PPM
Female sex is a strong clinical predictor of PPM after AVR, likely reflecting the smaller annulus area in women, making implantation of an adequately sized valve challenging.
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