1 INTRODUCTION
The phenomenon of prosthesis-patient mismatch (PPM), first described by Rahimtoola et al. in 1978,1 is a condition in which the effective orifice area (EOA) of an implanted valve prosthesis does not match the patient’s body size. Due to insufficient orifice area, PPM causes hemodynamics similar to valvular stenosis.
PPM after the aortic valve replacement has been well proven to be associated with higher incidences of long- and short-term adverse outcomes.2, 3 Insufficient orifice area in the left ventricular outflow causes increase in the left ventricular afterload, thus resulting in the left ventricular hypertrophy and diastolic dysfunction. Similar effect of PPM may be observed in the mitral position which may increase the afterload of the pulmonary circulatory system. Limited studies have evaluated the impact of PPM on the outcomes after mitral valve replacement (MVR).4-11 Further, most of these studies included both mitral stenosis (MS) and mitral regurgitation (MR).
Considering the different hemodynamic background of MS and MR, PPM may have more negative impact on hemodynamic after MR. The purpose of this study was to investigate the effect of PPM on bioprosthetic valve replacement after MR.