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Updated: Feb 9, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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The Prognostic Significance of Patient-Prosthesis Mismatch after Aortic Valve Replacement

Paolo Nardi1, Marco Russo1, Guglielmo Saitto1

  • 1Cardiac Surgery Division, Tor Vergata University Policlinic of Rome.

The Korean Journal of Thoracic and Cardiovascular Surgery
|June 2, 2018
PubMed

Insights

Patient-prosthesis mismatch (PPM) negatively impacts outcomes after aortic valve replacement, increasing mortality and valve deterioration. Preoperative planning is crucial to prevent PPM by selecting appropriate valves and surgical techniques.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Biomedical Engineering

Background:

  • Patient-prosthesis mismatch (PPM) is a debated clinical issue.
  • PPM is linked to increased mortality and cardiac events post-aortic valve replacement.
  • PPM is associated with accelerated structural valve deterioration in bioprostheses.

Purpose of the Study:

  • To review the current understanding of patient-prosthesis mismatch.
  • To discuss the implications of PPM in aortic valve replacement.
  • To highlight strategies for preventing PPM.

Main Methods:

  • Literature review of studies on patient-prosthesis mismatch.
  • Analysis of clinical data regarding PPM and patient outcomes.
  • Synthesis of current evidence on valve selection and surgical techniques.

Main Results:

  • PPM is associated with higher all-cause and cardiac mortality.
  • A correlation exists between PPM and biological prosthesis deterioration.
  • Preventive strategies are essential for at-risk patients.

Conclusions:

  • Careful preoperative assessment is vital to mitigate PPM risks.
  • Optimizing valve choice and surgical approach can prevent PPM.
  • Addressing PPM is critical for improving long-term prognosis after AVR.
Keywords:
Aortic valve replacementPatient-prosthesis mismatchPrognostic significance

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