Subramaniam Kathirvel, Nazarnia Soheyla
Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA.
Board Certified Cardiac Anesthesiologist, Tabriz, Iran.
Ann Card Anaesth. 2017 Apr-Jun;20(2):234-242. doi: 10.4103/aca.ACA_9_17.
Prosthesis-patient Mismatch (PPM) is not uncommon with an incidence reported up to 70% after aortic valve (AV) replacement. Severe forms of PPM are less common (up to 20%); PPM can lead to increased short- and long-term morbidity and mortality. It is important to discriminate PPM from other forms of prosthetic valve dysfunction. Sometimes, prosthetic valve degenerative disease may coexist with PPM. Echocardiography plays an important role in the prevention and diagnosis of PPM. Preemptive strategies to prevent PPM include insertion of newer generation prosthetic valves with better hemodynamic characteristics, stentless prosthesis, aortic root enlargement to insert a larger prosthesis, aortic homograft, and transcutaneous AV implantation. We present an illustrative case and review the literature on PPM pertinent to anesthesiologists.
人工瓣膜-患者不匹配（PPM）并不罕见，据报道，主动脉瓣（AV）置换术后的发生率高达70%。严重形式的PPM较少见（高达20%）；PPM可导致短期和长期发病率及死亡率增加。将PPM与其他形式的人工瓣膜功能障碍区分开来很重要。有时，人工瓣膜退行性疾病可能与PPM并存。超声心动图在PPM的预防和诊断中起着重要作用。预防PPM的先发策略包括植入具有更好血流动力学特性的新一代人工瓣膜、无支架人工瓣膜、扩大主动脉根部以植入更大的人工瓣膜、主动脉同种异体移植物以及经皮AV植入。我们展示了一个典型病例，并回顾了与麻醉医生相关的PPM文献。
