Con: Patient-prosthesis mismatch now is not an important consideration in the majority of patients after aortic valve replacement

摘要

BECAUSE PROSTHETIC HEART VALVES require structural support including a sewing ring, their ratio of available anatomic orifice area for a given geometric area is by nature smaller than that for normal native valves. The importance of this relationship first was recognized by Dr Shahbudin H. Rahimtoola, MB, FRCP, DSc and his associates in 1978, who termed this phenomenon "prosthesis-patient mismatch" (VP-PM). Further appreciation for the possibility of VP-PM developed with the subsequent widespread expansion of echo-cardiography and Doppler techniques, as the existence of elevated transaortic valve gradients were reported early after aortic valve replacement (AVR) in certain patients, particularly those who received small-sized prostheses