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J Am Coll Cardiol, 2000; 36:1131-1141 © 2000 by the American College of Cardiology Foundation |
a Quebec Heart Institute/Laval Hospital, Laval University, Sainte-Foy, Quebec, Canada
Manuscript received July 27, 1999; revised manuscript received March 27, 2000, accepted June 1, 2000.
Reprint requests and correspondence: Dr. Jean G. Dumesnil, Quebec Heart Institute, Laval Hospital, 2725 Chemin Sainte-Foy, Sainte-Foy, Quebec, Canada G1V-4G5
medjgd{at}hermes.ulaval.ca
Prosthesispatient mismatch is present when the effective orifice area of the inserted prosthetic valve is less than that of a normal human valve. This is a frequent problem in patients undergoing aortic valve replacement, and its main hemodynamic consequence is the generation of high transvalvular gradients through normally functioning prosthetic valves. The purposes of this report are to present an update on the concept of aortic prosthesispatient mismatch and to review the present knowledge with regard to its impact on hemodynamic status, functional capacity, morbidity and mortality. Also, we propose a simple approach for the prevention and clinical management of this phenomenon because it can be largely avoided if certain simple factors are taken into consideration before the operation.
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