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Valve prosthesis-patient mismatch (VP-PM): a long-term perspective
Samuel A Daneshvar1, Shahbudin H Rahimtoola
1Griffith Center, Division of Cardiovascular Medicine, Department of Medicine, LAC-USC Medical Center, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA.
Valve prosthesis/patient mismatch (VP-PM) is a critical factor in heart valve function. Standardizing its assessment is crucial for understanding its impact on patient outcomes and mortality.
Area of Science:
- Cardiology
- Biomedical Engineering
- Prosthetic Heart Valves
Background:
- Valve prosthesis/patient mismatch (VP-PM) has been recognized since 1978.
- Previous studies (pre-2011) yielded inconsistent conclusions regarding VP-PM.
- Variability in assessing effective orifice area index (EOAi) contributed to differing results.
Purpose of the Study:
- To critically evaluate the concept of VP-PM.
- To highlight the need for standardized assessment of VP-PM.
- To guide future research and clinical perspectives on VP-PM.
Main Methods:
- Review of existing literature on VP-PM.
- Analysis of factors influencing VP-PM assessment, including EOAi determination.
- Focus on severe/critical VP-PM and its relation to mortality.
Main Results:
- VP-PM is an inherent aspect of all prosthetic heart valves.
- Inconsistent EOAi measurement methods (projection vs. actual) and assessment criteria complicate VP-PM evaluation.
- Severe VP-PM is linked to mortality, necessitating causal determination.
Conclusions:
- VP-PM requires a proper clinical perspective by evaluating its impact on function and outcomes.
- Standardized assessment of VP-PM is essential for future research and clinical practice.
- Future efforts should focus on uniform VP-PM assessment and its clinical significance.
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