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PPM - prosthesis‐patient mismatch

Patient-prosthesis mismatch is a frequent cause of high postoperative gradients in normally functioning prostheses.

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The Relevance of Prosthesis-patient Mismatch After …

Prosthesis-patient mismatch (PPM) is associated with increased mid-term and long-term mortality rates after aortic valve replacement (AVR). This study aimed to evaluate the efficacy of the Carpentier-Edwards Perimount Magna and Magna Ease (CEPMs) aortic bioprostheses to reduce the incidence of PPM.

20/06/2005 · See p 3221 Valve prosthesis–patient mismatch ..

Rate of moderate patient-prosthesis mismatch (PPM), by group, postoperatively and at follow-up. There were no significant differences among the groups.

The problem of valve prosthesis–patient mismatch

To determine the association between prosthesis-patient mismatch and long-term survival after aortic valve replacement in adults.

Patient-prosthesis mismatch (PPM) may affect clinical outcomes in patients with aortic valve replacement (AVR). We retrospectively examined the PPM in patients with isolated AVR in the Japan Adult Cardiovascular Surgery Database (JACVSD).

Patient-prosthesis mismatch (PPM) may affect clinical outcomes in patients with aortic valve replacement (AVR). We retrospectively examined the PPM in patients with isolated AVR in the Japan Adult Cardiovascular Surgery Database (JACVSD).

Valve Prosthesis–Patient Mismatch (VP–PM) | JACC: …

Prosthesis-Patient Mismatch | JACC: Cardiovascular …

Patient-prosthesis mismatch (PPM) may affect clinical outcomes in patients with aortic valve replacement (AVR). Some clinical studies show differences in early and late outcomes in patients with PPM, but many are single-center studies. Prosthetic heart valves have a limited effective orifice area (EOA), although supra-annular type prostheses with a larger EOA are commercially available. People in the Eastern countries are physically smaller than those in the Western countries, and it is not always easy to implant a prosthetic valve of an adequate size in a smaller patient. Thus, the influence of PPM on clinical results after AVR should be clarified. We retrospectively examined PPM in patients with isolated AVR in Japan.

This case highlights a rare but potentially severe consequence of obesity in high-risk obstetric patients with previous cardiac valve replacements. The national rate of obesity in child-bearing age women continues to increase and outpace other demographics. As the obesity crisis continues, so too will the problems associated with obesity in pregnancy. As this case demonstrates, an unforeseen complication of obesity in pregnancy might occur in women with previous cardiac valve replacements. In this case, the pregnancy plus the prosthesis mismatch caused severe heart failure in a pregnant woman, severe enough to require a valve replacement during the pregnancy. Our discussion will highlight points concerning patient prosthesis mismatch and cardiopulmonary bypass surgery during pregnancy.

Patient prosthesis mismatch - SlideShare
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  • The concept of patient-prosthesis mismatch (PDF …

    Clinical predictors of prosthesis-patient mismatch after aortic valve replacement for aortic stenosis

  • The concept of patient-prosthesis mismatch

    Impact of prosthesis-patient mismatch on tricuspid valve regurgitation and ..

  • Patient-prosthesis mismatch after transapical aortic …

    Patient-prosthesis mismatch after transapical aortic valve implantation

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Prosthesis-patient mismatch: an update.

(A) Overall survival curves showing no significant differences among the 3 groups based on their risk of PPM. (B) Freedom from major adverse cardiovascular and cerebral events (MACCE) shows significant differences among the 3 groups. HR, high risk; LR, low risk; MR, medium risk; PPM, prosthesis-patient mismatch.

prosthesis-patient mismatch an update - PubMed Result

Aortic valve replacement (AVR) with a bioprosthesis is standard therapy for severe aortic stenosis, even in the era of transcatheter AVR (TAVR).,Older Asian people tend to be short in stature, and their aortic annulus is smaller than usual, proportionate to their body size. A previous study found that operative mortality generally decreased with increasing body surface area (BSA).Another problem in patients with a larger BSA and a small annulus is prosthesis-patient mismatch (PPM).,A previous study showed that the effect of PPM on mortality was greater in patients It has been suggested that PPM has a significant effect on short-term and long-term outcomes.

Patient-Prosthesis Mismatch - The Annals of Thoracic …

In view of the above, the following points need to be emphasised. Firstly, it is not the size (labelled size or IGA) of the prosthesis that matters but rather its EOA and in whom you implant it. Secondly, the only parameter yet shown to be valid to define PPM is the indexed EOA. Thirdly, the indexed IGA and labelled valve size cannot be used to identify PPM or to characterise its severity. To avoid any confusion about the interpretation of results of the different studies, the terminology used to describe these phenomena also apparently must be consistent and without ambiguity. Hence, “indexed orifice area” should not be used without specifying whether it is the indexed IGA or the indexed EOA. Also, given that the term PPM stems from a haemodynamic concept, its use should be reserved for data relating to haemodynamic function (that is, indexed EOAs and gradients), whereas the results of studies based on the analysis of the IGA or labelled valve size would be more appropriately described in terms of patient‐prosthesis size but without using the term mismatch, thus avoiding much confusion. The use of adequate terminology has important clinical implications, since, as mentioned, patient‐prosthesis size has little relevance to adverse clinical outcomes, whereas PPM can be viewed as a major risk factor in this regard.,,,,,,,,,,,,

patient-prosthesis mismatch in the ..

Prosthesis‐patient mismatch (PPM) is present when the effective orifice area of the inserted prosthetic valve is too small in relation to body size. Its main haemodynamic consequence is to generate higher than expected gradients through normally functioning prosthetic valves. This review updates the present knowledge about the impact of PPM on clinical outcomes. PPM is common (20–70% of aortic valve replacements) and has been shown to be associated with worse haemodynamic function, less regression of left ventricular hypertrophy, more cardiac events, and lower survival. Moreover, as opposed to most other risk factors, PPM can largely be prevented by using a prospective strategy at the time of operation.

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