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.