Pibarot P, Dumesnil J G
Quebec Heart Institute/Laval Hospital, Laval University, Sainte-Foy, Canada.
J Am Coll Cardiol. 2000 Oct;36(4):1131-41. doi: 10.1016/s0735-1097(00)00859-7.
Prosthesis-patient mismatch is present when the effective orifice area of the inserted prosthetic valve is less than that of a normal human valve. This is a frequent problem in patients undergoing aortic valve replacement, and its main hemodynamic consequence is the generation of high transvalvular gradients through normally functioning prosthetic valves. The purposes of this report are to present an update on the concept of aortic prosthesis-patient mismatch and to review the present knowledge with regard to its impact on hemodynamic status, functional capacity, morbidity and mortality. Also, we propose a simple approach for the prevention and clinical management of this phenomenon because it can be largely avoided if certain simple factors are taken into consideration before the operation.
当植入的人工瓣膜的有效瓣口面积小于正常人体瓣膜时，就会出现人工瓣膜与患者不匹配的情况。这在接受主动脉瓣置换术的患者中是一个常见问题，其主要血流动力学后果是通过功能正常的人工瓣膜产生高跨瓣压差。本报告的目的是介绍主动脉人工瓣膜与患者不匹配概念的最新情况，并回顾目前关于其对血流动力学状态、功能能力、发病率和死亡率影响的知识。此外，我们提出一种简单的方法来预防和临床处理这种现象，因为如果在手术前考虑某些简单因素，这种情况在很大程度上是可以避免的。
