Case Report: Prothesis-patient mismatch after aortic valve replacement

Area of Science:

• Cardiology
• Biomedical Engineering
• Cardiac Surgery

Background:

• Prosthetic heart valves (PHVs) are smaller than native valves, leading to inherent stenosis.
• Accurate PHV sizing and selection are critical to avoid complications and ensure optimal hemodynamics.
• Patient-prosthesis mismatch (PPM) is a recognized long-term complication with significant clinical consequences.

Observation:

• A 78-year-old male patient underwent aortic valve replacement for severe aortic stenosis.
• The patient experienced recurrent shortness of breath and decompensated congestive heart failure (CHF) post-surgery.
• These complications suggest a potential issue with patient-prosthesis mismatch.

Findings:

• PPM evaluation is insufficiently emphasized in clinical practice.
• Failure to recognize PPM can result in hemodynamic impairment and clinical deterioration.
• This case highlights the importance of pre-operative assessment for PPM risk.

Implications:

• Identifying patients at risk for PPM can decrease its prevalence and associated healthcare costs.
• Standardized pre-operative protocols are needed to minimize the risk of PPM.
• Addressing PPM proactively can improve long-term clinical outcomes and reduce morbidity and mortality.