The appreciation of prosthetic heart valves

Abstract

According to its definition, prosthesis-patient mismatch is present when the cardiac output of the patient is too large for the opening of a prosthetic valve. This causes symptoms similar to native aortic stenosis, which can lead to heart failure and mortality. To classify patients with PPM, a cut-off value of indexed effective orifice area is used in clinical practice.This thesis evaluates the underlying assumptions of using indexed effective orifice area as a parameter of valve performance. As these assumptions are inaccurate, the current definition of prosthesis-patient mismatch is unsuitable to diagnose patients with too small prosthetic valves after aortic valve replacement.