HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Eugene H. Blackstone Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gillinov, A. M. Articles by Rodriguez, L. L. Search for Related Content PubMed PubMed Citation Articles by Gillinov, A. M. Articles by Rodriguez, L. L. Related Collections Valve disease

J Thorac Cardiovasc Surg 2003;126:313-316
© 2003 The American Association for Thoracic Surgery

Editorial

Prosthesis-patient size: measurement and clinical implications

^a the Departments of Cardiothoracic Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
^c Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
^b Biostatistics, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

Received for publication September 19, 2002; accepted for publication October 17, 2002.

^* Address for reprints: A. Marc Gillinov, MD, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation/F25, 9500 Euclid Ave, Cleveland, OH 44195 USA.
gillinom@ccf.org

The first 300 words of the full text of this article appear below.

"Mismatch can be considered to be present when the effective prosthetic valve area, after insertion into the patient, is less than that of a normal human valve...occasionally it can be a severe problem because the patient may be hemodynamically and symptomatically worse after valve replacement."

This is the definition of prosthesis-patient mismatch framed by Rahimtoola¹ when he coined the term in 1978. Rahimtoola suggested that the degree of prosthesis-patient mismatch could be quantified and that such quantification might aid in identifying patients at risk of clinical sequelae caused by this condition. DeCarlo and colleagues² seek to undertake these tasks in their report on small-sized Sorin Bicarbon prostheses (Sorin Biomedica, Saluggia, Italy). Although seemingly straightforward, application of Rahimtoola’s definition requires examination and clarification of several complex concepts, including (1) measurement of prosthesis size, (2) measurement of patient size, (3) normalization of these values, (4) selection of referent values, and (5) assessment of the influence of prosthesis-patient size on clinical outcome.

Prosthesis Size

Prosthesis size can be based on either geometric dimensions or functional performance of the prosthesis (Table 1). Geometric expressions of prosthesis size include labeled size and internal orifice size. Functional expressions of prosthesis size include both in vitro and in vivo effective orifice area (EOA).

This article has been cited by other articles:

				P. Totaro and V. Argano Patient prosthesis mismatch after mitral valve replacement: Myth or reality? J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 697 - 701. [Abstract] [Full Text] [PDF]

				C. R. Bridges, S. M. O'Brien, J. C. Cleveland, E. B. Savage, J. S. Gammie, F. H. Edwards, E. D. Peterson, and F. L. Grover Association between indices of prosthesis internal orifice size and operative mortality after isolated aortic valve replacement J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 1012 - 1021. [Abstract] [Full Text] [PDF]

				W. Flameng, B. Meuris, P. Herijgers, and M.-C. Herregods Prosthesis-Patient Mismatch is Not Clinically Relevant in Aortic Valve Replacement Using the Carpentier-Edwards Perimount Valve Ann. Thorac. Surg., August 1, 2006; 82(2): 530 - 536. [Abstract] [Full Text] [PDF]

				M. R. Moon, M. K. Pasque, N. A. Munfakh, S. J. Melby, J. S. Lawton, N. Moazami, J. E. Codd, T. D. Crabtree, H. B. Barner, and R. J. Damiano Jr Prosthesis-Patient Mismatch After Aortic Valve Replacement: Impact of Age and Body Size on Late Survival Ann. Thorac. Surg., February 1, 2006; 81(2): 481 - 489. [Abstract] [Full Text] [PDF]

				H.-H. Sievers Prosthetic aortic valve replacement J. Thorac. Cardiovasc. Surg., May 1, 2005; 129(5): 961 - 965. [Full Text] [PDF]

				E. Otero, J. L. Pomar, J. M. Revuelta, and J. J. Rufilanchas Comparative Evaluation of Small-Size Sorin Slimline and St. Jude HP Heart Valve Prostheses Ann. Thorac. Surg., April 1, 2005; 79(4): 1284 - 1290. [Abstract] [Full Text] [PDF]

				J. G. Dumesnil and P. Pibarot Prosthesis size and prosthesis-patient size are unrelated to prosthesis-patient mismatch J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1852 - 1852. [Full Text] [PDF]

				E. H. Blackstone, A. M. Gillinov, and D. M. Cosgrove Reply to the Editor J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1852 - 1854. [Full Text] [PDF]