Pibarot P, Dumesnil J G
Research Group in Valvular Heart Disease, Laval Hospital Research Centre/Quebec Heart Institute, Laval University, Sainte-Foy, Quebec, Canada.
Heart. 2006 Aug;92(8):1022-9. doi: 10.1136/hrt.2005.067363. Epub 2005 Oct 26.
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.
当植入的人工瓣膜的有效瓣口面积相对于身体大小过小,就会出现人工瓣膜-患者不匹配(PPM)。其主要血流动力学后果是通过正常工作的人工瓣膜产生高于预期的压力阶差。本综述更新了关于PPM对临床结局影响的现有知识。PPM很常见(在主动脉瓣置换术中占20%-70%),并且已被证明与血流动力学功能较差、左心室肥厚消退较少、更多心脏事件以及较低生存率相关。此外,与大多数其他危险因素不同,PPM在很大程度上可以通过手术时采用前瞻性策略来预防。