Heart Valve Prosthesis-Patient Mismatch
Heart Valve Prosthesis-Patient Mismatch
The purpose of this study is to determine the frequency of prosthesis-patient mismatch after
 mitral valve replacement and its effect on clinical outcomes.
Mitral valve replacement (MVR) is associated with higher short and long term mortality than
 aortic valve replacement or mitral valve repair. The suboptimal results of MVR underline the
 importance of identifying and preventing prosthesis- patient mismatch. The effective orifice
 area (EOA) of prosthetic valves used for MVR is often too small in relation to body size,
 thus causing a mismatch between valve EOA and transvalvular flow. As a consequence, normally
 functioning mitral prostheses often have relatively high gradients that are similar to those
 found in patients with mild to moderate mitral stenosis. Residual pressure gradients across
 mitral prostheses delay the regression of left atrial and pulmonary arterial hypertension.
 Pulmonary hypertension may cause rightsided failure and is an important risk factor for
 morbidity and mortality in patients with cardiovascular diseases. However data about the
 frequency of prosthesis-patient mismatch after mitral valve replacement and its effect on
 clinical outcome is inconclusive. Predetermined outcomes will be evaluated in the clinical
 course of this condition.
Inclusion Criteria:

 -  Patients > 18 years with a clinical condition of mitral valve prosthesis

 Exclusion Criteria:

 -  Evidence of prosthesis valve dysfunction (dehisence, endocarditis or thrombus of
 prosthetic mitral valve)

 -  Concomitant aortic valve prosthesis and tricuspid valve prosthesis

 -  Presence of > +2 aortic valve regurgitation and/or mild aortic stenosis

 -  Prosthetic mitral valve replacement operation < 6 months

 -  Left ventricular ejection fraction < 50%

 -  Chronic obstructive pulmonary disease

 -  Concomitant hypertrophic cardiomyopathy, atrial septal defect

 -  Patients with poor ehocardiographic window