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ISSN 2448-5640 (Print)
Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2019, Number 3

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Cir Card Mex 2019; 4 (3)

Aortic valve prosthesis-patient mismatch: Pro pane lucrando? Res non verba!

García-Villarreal OA

Language: English
References: 9
Page: 93-95
PDF size: 142.32 Kb.


ABSTRACT

Aortic prosthesis-patient mismatch (PPM) has been registered and logged as one of the most powerful predictors for poor prognosis at a long-term follow up after aortic valve replacement. New and more recent prosthtetic models have reached such a perfection that the obtained gradients are increasingly lower. Such is the case between the 19 mm monostrut mechanical aortic heart valve and SJM Regent (0.8 cm2 vs 1.6 cm2, respectively). We show one case herein about a female patient underwent mitral and aortic mechanical replacement plus tricuspid annuloplasty. Over 19 years, she developed impairment in NYHA funcitonal class III. Important patient-prosthesis mismatch was identified. With no other alternative than simple re-replacement (because of the mitral prosthesis in situ), the 19 mm monostrut mono-leaflet prosthesis was taken away and a 19 mm bileaflet SJM Regent was inserted instead of. Patient course was uneventful with no important gradient or any mismatch aortic valve-relate. Patient prosthesis relationship highly improved from 0.47 up to 0.94. This simple case illustrates very well how important is the preliminary calculation of the patient- prosthesis match befofe operation.


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