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Updated: Jun 8, 2026
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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Does patient-prosthesis mismatch affect long-term results after mitral valve replacement?
Hiroaki Sakamoto1, Yasunori Watanabe
1Department of Cardiovascular Surgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan.
Summary
Patient-prosthesis mismatch (PPM) of the mitral valve does not impact outcomes after mitral valve replacement (MVR). This study found no significant differences in mortality or heart failure recurrence between PPM and non-PPM groups.
Area of Science:
- Cardiovascular Surgery
- Prosthetic Heart Valves
- Echocardiography
Background:
- Patient-prosthesis mismatch (PPM) of the mitral valve is a debated topic.
- Previous studies on mitral valve PPM outcomes remain controversial.
Purpose of the Study:
- To investigate the impact of mitral valve PPM on clinical outcomes following mitral valve replacement (MVR).
Main Methods:
- Retrospective analysis of 84 patients undergoing MVR between 1992 and 2005.
- Patients were categorized into PPM and non-PPM groups based on indexed effective orifice area (IEOA) derived from echocardiography.
- PPM defined as IEOA ≤ 1.2 cm²/m².
Main Results:
- No significant difference in 30-day mortality between groups.
- Postoperative pulmonary artery pressure and mitral valve pressure gradient showed no significant differences.
- Freedom from heart failure recurrence and cardiac death was similar in both groups.
Conclusions:
- Mitral valve PPM, as defined (IEOA ≤ 1.2 cm²/m²), does not adversely affect short- or long-term outcomes after MVR.
- The impact of a more severe PPM definition (IEOA ≤ 1.0 cm²/m²) requires further investigation.
- Additional research is needed to determine the acceptable range for IEOA.
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