Key result
Evaluating valve prosthesis-patient mismatch requires uniform effective orifice area index and focus on severe cases.
Why the study?
Studies on valve prosthesis-patient mismatch have reached varying conclusions due to projected rather than measured effective orifice area index, variable severity criteria, and differing timing of determination.
Standardized measurement of effective orifice area index is needed to accurately assess the clinical impact of valve prosthesis-patient mismatch.
Answers are grounded in this paper and cite their sources.
Current VP-PM data warrant cautious interpretation due to inconsistent criteria; leaves open uniform assessment to clarify mortality effects.
The concept/phenomenon of valve prosthesis/patient mismatch (VP-PM), described in 1978, has stood the test of time. From that time to 2011, VP-PM has received a great deal of attention but studies have come to varying conclusions. This is largely because of the determination of prosthetic heart valve area [called effective orifice area index (EOAi)] by projection rather than by actual measurement, variable criteria to assess severity of EOAi and the timing of determination of EOAi. All prosthetic heart valves have some degree of VP-PM which must be placed in a proper clinical perspective. This can be done by determining its effects on function and outcomes. For mortality one needs to focus especially on severe/critical degree of VP-PM and determine the cause of death was due to VP-PM. For the period "beyond 2011" a road map is suggested that will have uniformity of assessment of VP-PM and a focusing on the important goals of VP-PM.
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Daneshvar et al. (2012) conducted a review in Valve Prosthesis-Patient Mismatch. Valve Prosthesis-Patient Mismatch was evaluated. Valve prosthesis-patient mismatch requires uniform assessment of effective orifice area index and a focus on severe degrees to accurately determine its effects on mortality and clinical outcomes.
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