Until very recently, warfarin is still the best drug of choice for long-term anticoagulation for patients with mechanical prosthetic heart valve. However, the complication of warfarin account for 75 percent of the whole complication after the mechanical prosthetic heart valve replacement.. Interindividual variation in warfarin dose is mediated by multiple factors.Advanced models using combinations of clinical attributes and genetic factors(CYP2C9, VKORC1, and CYP4F2) explain 50-75% of variability in warfarin dose requirements.These warfarin dosing models have the potential to improve patient safety by reducing or eliminating serious adverse events. The investigators conducted a prospective, randomized, blinded, two arm trial to test this hypothesis. ...
According to the latest market report published by Persistence Market Research titled Global Transcatheter Heart Valve Replacement & Repair Market: Global Industry Analysis and Forecast, 2016 - 2026, the global transcatheter heart valve replacement & repair market is projected to expand at a CAGR of 13.9% during the forecast period (2016-2026).. Request for Report [email protected]://www.persistencemarketresearch.com/samples/11167. Transcatheter heart valve replacement is a relatively non-invasive procedure to repair the damaged heart valves with bioprosthetic valves for treatment of valvular heart disease namely aortic stenosis and mitral regurgitation among geriatric population. It is an alternative approach to conventional open heart surgery, especially for extremely high risk patients. Transcatheter heart valve replacement & repair market was valued at US$ 1,605.5 Mn in 2015 and the revenue is expected to increase to US$ 6,701.5 Mn by 2026 at a CAGR of 13.9% over the forecast period.. The report ...
A tissue valve type heart valve prosthesis is disclosed which has a biocompatible plastic sewing ring adapted to be surgically implanted into the mitral, aortic or tricuspid annulus of the human heart. The sewing ring has internal square threads and a biocompatible fabric mesh or cloth is embedded into the sewing ring so that the cloth can be fully wrapped around the sewing ring covering all of its plastic surfaces except for the internally protruding threads. A biocompatible plastic stent support ring has externally disposed threads to lock with the threads of the sewing ring in approximately one turn, or less. The stent support ring also embeds a biocompatible fabric mesh which can be wrapped around the stent support ring to cover all of its plastic surfaces, except for the protruding threads, and to form a cloth pocket wherein a solid stent is mounted. A porcine trileaflet valve is mounted to the stent. When the heart valve prosthesis is as implanted into the heart, the threads of the sewing ring
TY - JOUR. T1 - Forty-year survival with the starr-edwards heart valve prosthesis. AU - Gao, Guangqiang. AU - Wu, Ying Xing. AU - Grunkemeier, Gary L.. AU - Furnary, Anthony P.. AU - Starr, Albert. PY - 2004/1/1. Y1 - 2004/1/1. N2 - Background and aim of the study: The study aim was to update an analysis of the long-term survival of heart valve replacement using the Starr-Edwards prosthesis. Methods: Cases of isolated aortic (AVR, n = 2,247) and mitral (MVR, n = 1,406) valve replacement with Starr-Edwards prostheses implanted between 1960 and 1997, with follow up to 2003, were reviewed. Introduced in 1965, the Models A1200/1260, M6120 are still in use (Current), while other models have been discontinued (Discontinued). For AVR, 938 valves were Discontinued, with a total follow up of 8,506 patient-years (pt-yr) and a maximum of 41 years; by comparison, 1,309 valves were Current, with a total follow up of 11,586 pt-yr and a maximum of 36.1 years. For MVR, 635 valves were Discontinued, with a total ...
Export Data And Price Of On X Prosthetic Heart Valve , www.eximpulse.com Eximpulse Services is the place where you can find the recent and updated Trade intelligence report of On X Prosthetic Heart Valve Export Data. Whole information is based on updated Export shipment data of Indian Customs. All the compilation is done on the basis of All India ports data and has been done on daily basis. This helps you to get all India On X Prosthetic Heart Valve Export data. You can find previous two days On X Prosthetic Heart Valve Export data on Eximpulse Services. On X Prosthetic Heart Valve Export data can be useful in different kind of analysis such as: Export price, Quantity, market scenarios, Price trends, Duty optimization and many more. Some Sample Shipment records for On X Prosthetic Heart Valve Export Data of India are mentioned above. Further for Free sample and pricing of detailed reports contact on [email protected] Data post 2012 as per Notification No.18/2012 - Customs(N.T.) and does not ...
RnRMarketResearch.com adds report "Australia Prosthetic Heart Valves Market Outlook to 2020" to its store.. "Australia Prosthetic Heart Valves Market Outlook to 2020″, provides key market data on the Australia Prosthetic Heart Valves market. The report provides value, in millions of US dollars, and volume (in units) and average price data (in US dollars), within market categories Mechanical Heart Valves, Tissue Heart Valves and Transcatheter Heart Valves.. The report also provides company shares and distribution shares data for the market category, and global corporate-level profiles of the key market participants, pipeline products, and news and deals related to the Prosthetic Heart Valves market wherever available.. Inquire For Discount @ http://www.rnrmarketresearch.com/contacts/discount?rname=179196 .. The data in the report is derived from dynamic market forecast models. GlobalData uses epidemiology and capital equipment-based models to estimate and forecast the market size. The objective ...
The prosthetic heart valve device market was the sixth largest market in the global cardiovascular devices market in 2016. Prosthetic Heart Valve Device Market Global Briefing 2017 from The Business Research Company provides the strategists, marketers and senior management with the critical information they need to assess the global prosthetic heart valve device market.. The Prosthetic Heart Valve Device Market Global Briefing Report from The Business Research Company covers market characteristics, size and growth, segmentation, regional breakdowns, competitive landscape, market shares, trends and strategies for this market.. Browse full report with table of content @ http://www.radiantinsights.com/research/prosthetic-heart-valve-device-market-global-briefing-2017. The prosthetic heart valve device market is one of the segments in the cardiovascular devices market, within the medical equipment market.. The market characteristics section of the report defines and explains the market.. The market ...
Fifty eight patients (aged 8-59 years, mean 27) treated for prosthetic valve endocarditis from January 1966 to January 1985 were studied retrospectively by review of case notes. There were 12 cases of early and 46 cases of late prosthetic valve endocarditis. These developed in 28 patients with an isolated aortic valve, in 26 with an isolated mitral valve, and in four with both aortic and mitral prosthetic valves. Streptococci were the most commonly isolated microorganisms, followed by staphylococci, Gram negative bacteria, and fungi. A surgical (34 cases) or a necropsy specimen (10 cases) from 44 cases was examined. Eighty two per cent of the patients had congestive heart failure. Twenty four of the 58 patients were medically treated and 17 died (70% mortality). Combined medical and surgical treatment was used in 34 patients; the main indication for surgery was congestive heart failure. Fourteen patients on combined treatment died (40% mortality). Persistent sepsis and prosthetic valve ...
Edwards SAPIEN XT transcatheter heart valve with the NOVAFLEX+ delivery system. Indications: The Edwards SAPIEN XT transcatheter heart valve is indicated for use in patients with symptomatic heart disease due to either severe native calcific aortic stenosis or failure (stenosed, insufficient, or combined) of a surgical bioprosthetic aortic valve who are judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy (i.e., Society of Thoracic Surgeons operative risk score ≥ 8% or at a ≥ 15% risk of mortality at 30 days).. Contraindications: The THV and delivery systems are contraindicated in patients who cannot tolerate an anticoagulation/antiplatelet regimen or who have active bacterial endocarditis or other active infections.. Warnings: Observation of the pacing lead throughout the procedure is essential to avoid the potential risk of pacing lead perforation. There is an increased risk of stroke in transcatheter aortic valve replacement ...
0005] The present invention provides molds for shaping at least one leaflet of a prosthetic heart valve (e.g., aortic, pulmonary, triscuspid, or mitral replacement valves), and methods for fabricating a prosthetic heart valve and prosthetic heart valve assembly using the same. In one aspect of the invention, the molds or fixtures used for forming leaflets allow for selective exposure of solution to certain portions of the tissue during the fixation process. That is, one surface of the tissue used for the leaflets is directly exposed to the fixation solution since there is no portion of the fixture or mold that is in contact with the exposed or outwardly facing surface of the leaflet tissue. In addition, the surface of the mold or fixture that is in contact with one surface of the tissue (i.e., the side of the tissue that is opposite the outwardly facing surface) is relatively smooth in order to prevent impressions or other tissue damage. In the area of the skirt or area surrounding the leaflets, ...
An experimental study is reported which investigates the wall shear stress (WSS) distribution in a transparent model of the human aorta comparing a bileaflet mechanical heart valve (BMHV) with a trileaflet mechanical heart valve (TMHV) in physiological pulsatile flow. Elastic micro-pillar WSS sensors, calibrated by micro-Particle-Image-Velocimetry measurement, are applied to the wall along the ascending aorta. Peak WSS values are observed almost twice in BMHV compared to TMHV. Flow field analyses illuminate that these peaks are linked to the jet-like flows generated in the valves interacting with the aortic wall. Not only the magnitude but also the impact regions are specific for the different valve designs. The side-orifice jets generated by BMHV travel along the aortic wall in the ascending aorta and cause a whole range impact, while the jets generated by TMHV impact further downstream in the ascending aortic generating less severe WSS.. ...
A method for producing an aortic or mitral heart valve prosthesis and the resulting aortic or mitral heart valve. The method is characterized in that it essentially consists in producing the prosthesis by shaping a textile material. The invention is more particularly applicable in the field of medicine, in particular repair surgery, and especially in heart surgery, more particularly heart prostheses.
Press Release issued Feb 23, 2017: According to the latest market report published by Persistence Market Research titled Global Transcatheter Heart Valve Replacement & Repair Market: Global Industry Analysis and Forecast, 2016 - 2026, the global transcatheter heart valve replacement & repair market is projected to expand at a CAGR of 13.9% during the forecast period (2016-2026).
The Edwards SAPIEN 3 Transcatheter Heart Valve System and Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System are indicated for relief of aortic stenosis in patients with symptomatic heart disease due to severe native calcific aortic stenosis who are judged by a Heart Team, including a cardiac surgeon, to be appropriate for the transcatheter heart valve replacement therapy.. The Edwards SAPIEN 3 Transcatheter Heart Valve System and Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System are indicated for patients with symptomatic heart disease due to failure (stenosed, insufficient, or combined) of a surgical bioprosthetic aortic or mitral valve who are judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy (i.e., predicted risk of surgical mortality ≥ 8% at 30 days, based on the STS risk score and other clinical co-morbidities unmeasured by the STS risk calculator).. Contraindications (Who should not use): ...
BACKGROUND There is a paucity of controlled trials comparing the merits of different heart valve prostheses. In this prospective randomized trial we compared Starr Edwards and St. Jude prostheses in the aortic and mitral positions. METHODS Two hundred sixty-seven patients and 122 patients undergoing aortic and mitral valve replacement, respectively, were allocated by minimization to receive either St. Jude or Starr Edwards prostheses. Patients (2 patients were lost to follow-up) were followed up in a special clinic. Event definition, recording, and reporting were in accordance with published guidelines. RESULTS There were no demographic differences between patients receiving the two different valve models. With the exception of infective endocarditis, we found no differences in the rates of death or complication between patients receiving a Starr Edwards prosthesis or a St. Jude prosthesis in either position. Neither were there any differences between the two valve models in either position, in
A flexible non-stented heart valve prosthesis made from a flat piece of a stabilized biological membrane. The membrane is folded along one or more folding lines and attached to a flat flexible non-bio
The Edwards SAPIEN 3 Transcatheter Heart Valve System and Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System are indicated for relief of aortic stenosis in patients with symptomatic heart disease due to severe native calcific aortic stenosis who are judged by a Heart Team, including a cardiac surgeon, to be appropriate for the transcatheter heart valve replacement therapy.. The Edwards SAPIEN 3 Transcatheter Heart Valve System and Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System are indicated for patients with symptomatic heart disease due to failure (stenosed, insufficient, or combined) of a surgical bioprosthetic aortic or mitral valve who are judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy (i.e., predicted risk of surgical mortality ≥ 8% at 30 days, based on the STS risk score and other clinical co-morbidities unmeasured by the STS risk calculator).. Contraindications (Who should not use): ...
The study, which used data from the Registry of Pregnancy and Cardiac Disease, looked at 2,966 women with structural cardiac disease, aortic pathology or pulmonary hypertensions from 132 centers in 48 countries. Of these women, 212 had mechanical heart valves, 134 had tissue valves and 2,620 had no prosthetic valves.. According to the study, only 58 percent of women with mechanical valves had event-free pregnancies resulting in live births, compared to 78 percent of other cardiac patients. The percentage of women who suffered maternal mortality (1.4 percent), thrombotic events (6.1 percent), hemorrhagic events (23 percent), miscarriages after 24 weeks (15.6 percent) and fetal mortality less than 24 weeks (2.8 percent) were much higher than those with no prosthesis or tissue valves (0.2 percent, 0.4 percent, 5 percent, 1.7 percent and 0.6 percent, respectively).. Anticoagulation regimes made up of vitamin K antagonists, low molecular weight heparin, unfractured heparin or combinations of the ...
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Valve Guide (valveguide.ch) is a reference website for prosthetic heart valves and annuloplasty rings. It should support heart valve specialist in searching size-specific information on prosthetic heart valves and annuloplasty ring systems.
Valve Guide (valveguide.ch) is a reference website for prosthetic heart valves and annuloplasty rings. It should support heart valve specialist in searching size-specific information on prosthetic heart valves and annuloplasty ring systems.
Suturing rings and methods of use thereof facilitating initial implantation of new and replacement of dysfunctional tissue or mechanical heart valve mechanisms supported by the suturing ring are disclosed. The suturing ring annulus is adjustable to receive and engage the valve frame of the heart valve mechanism within the annulus. An interlocking mechanism applies restraint to fix the adjusted suturing ring annulus engaged against the valve frame to support the heart valve mechanism during chronic implantation. Sutures affixing the suturing ring to the valvar rim can be routed and entrapped between the suturing ring annulus and the valve frame when the suturing ring is restraint is applied. The restraint is released to replace a dysfunctional heart valve mechanism and reapplied when a new heart valve mechanism is fitted into the annulus.
Prospective, randomized, controlled, multi-center trial. Patients having an operative mortality , 2% (low operative risk) for surgical aortic valve replacement will be randomized 1:1 to receive either transcatheter heart valve replacement (TAVR) with the Edwards SAPIEN 3 or aortic valve replacement with a commercially available surgical bioprosthetic valve. Patients will be seen for follow-up visits at discharge, 30 days, 6 months, and annually through 10 years ...
A valve delivery device and method of use is provided. In one embodiment, a method for attaching a valve prosthesis to a target tissue includes providing a ring having a portion defining a groove and a plurality of fasteners coupled to the ring. A portion of the valve prosthesis is placed in the groove on the ring. The valve prosthesis portion in the groove is then secured to the ring. The ring is mounted on a delivery device and the delivery device is positioned so that the fasteners will engage the target tissue when the fasteners are deployed. A shaped plunger member may then deployed through an interior of the ring to swing said fasteners from a first position to a second tissue engagement position.
Valvular heart disease accounts for a substantial part of the cardiovascular disease worldwide with an estimated prevalence of 2.5% in the Western population aged ,65 years and over 13% in the population aged ,75 years. Surgical prosthetic heart valve (PHV) replacement is the indicated therapy for severe valve disease or ... read more in symptomatic patients. PHV-related complications are serious and potentially life threatening and include structural valve deterioration, regurgitation, endocarditis and obstruction. Acquired PHV obstruction is mostly caused by valve thrombosis or pannus (fibrous subprosthetic tissue), whereas valve obstruction presenting early after implantation may be caused by patient prosthesis mismatch. Depending on the cause and severity of dysfunction, the treatment may include antibiotic therapy, anticoagulant therapy, fibrinolysis, redo valve surgery or valve-in-valve implantation and is associated with high morbidity and mortality. Hence, baseline and follow-up imaging ...
In an effort to decrease the incidence of thromboembolic phenomena associated with prosthetic replacement of the mitral valve and to eliminate problems associated with swelling of moving parts employed in cardiac valve prostheses, a new mitral Teflon disc valve made of titanium was designed. The cage legs are covered with Teflon to reduce wear, and the entire sewing ring and base are covered with Dacron velour to encourage rapid tissue encapsulation. After accelerated fatigue testing and animal investigations, preliminary results in a clinical series of 73 patients appear most encouraging. Further time must pass, however, before statistically valid conclusions can be reached.. ...
A prominent performance metric used by the FDA to evaluate prosthetic heart valves is transvalvular pressure drop. ... METHODS To investigate vortex ring formation as a function of time relative to changing operating conditions, a piston driven heart simulator (Vivitro Heart system SD2001-1) was used. ... (3) The data collected from the Vivitro Heart system was used to find . .... Go to the Article ...
The present invention comprises a method for deploying an aortic valve prosthesis. This valve prosthesis may include any of the known aortic valves including, but not limited to, stented and unstented bioprosthetic valves, stented mechanical valves, and expandable or self-expanding valves, whether biological or artificial. The method involves the steps of: making a first opening leading to the left atrium; passing a valve prosthesis through the opening and into a cardiac chamber of the left side of the heart using a first manipulation instrument; making a second opening in the arterial system and advancing one end of a second manipulation instrument through the arterial opening and into the aforementioned cardiac chamber; securing the second manipulation instrument to the valve prosthesis; and using the second manipulation instrument to retract at least some portion of the valve prosthesis out of the aforementioned cardiac chamber.
Chew, Y.T.,Low, H.T.,Lee, C.N.,Kwa, S.S. (1993). Laser anemometry measurements of steady flow past aortic valve prostheses. Journal of Biomechanical Engineering 115 (3) : 290-298. [email protected] Repository ...
TY - JOUR. T1 - Flow through a defective mechanical heart valve. T2 - A steady flow analysis. AU - Smadi, O.. AU - Fenech, M.. AU - Hassan, Ibrahim. AU - Kadem, L.. PY - 2009/4. Y1 - 2009/4. N2 - Approximately 250,000 valve replacement operations occur annually around the world and more than two thirds of these operations use mechanical heart valves (MHV). These valves are subject to complications such: pannus and/or thrombus formation. Another potential complication is a malfunction in one of the valve leaflets. Although the occurrence of such malfunctions is low, they are life-threatening events that require emergency surgery. It is, therefore, important to develop parameters that will allow an early non-invasive diagnosis of such valve malfunction. In the present study, we performed numerical simulations of the flow through a defective mechanical valve under several flow and malfunction severity conditions. Our results show that the flow upstream and downstream of the defective valve is ...
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Valvular heart disease is accompanied by a high mortality/morbidity and often requires prosthetic heart valve (PHV) replacement in order to improve quality of life and survival. The major drawback of both mechanical and biological PHV implantations is development of dysfunction, which is a life threatening condition. Cardiac imaging has a ... read more pivotal role in determining the correct treatment strategy for patients with PHV dysfunction. In clinical practice however the correct detection of PHV dysfunction remains difficult. Diagnostic dilemmas are predominantly encountered in PHV obstruction and endocarditis. In this thesis the diagnostic role of routine imaging techniques (fluoroscopy and two-dimensional transthoracic (TTE) and transesophageal (TEE) echocardiography) for PHV endocarditis and obstruction was determined and compared. Moreover, the additional value of novel imaging techniques on top of routine diagnostics was investigated. Results for PHV endocarditis: Two dimensional TEE ...
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The Edwards SAPIEN 3 THV System and Edwards SAPIEN 3 Ultra THV System were previously approved for the treatment of severe aortic stenosis (a narrowing of the aortic valve that restricts blood flow to aorta, the bodys main artery) in patients at intermediate and greater risk for surgical therapy.
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Emily Jane s Discussions | Mechanical Heart Valve support group for people who are having mechanical heart valve & artificial & plastic heart valve re…
Ryan Saccuccis Discussions | Mechanical Heart Valve support group for people who are having mechanical heart valve & artificial & plastic heart valve…
Innovative prosthetic device, preventing the drawbacks of the currently implanted transcatheter heart valves. Techology adapted to non critical patients, opening new horizons for percutaneous implantation. ...
An improved valve prosthesis for mitral and tricuspid heart valves, the valve prosthesis being configurated as an open ring and covered with a double velour fabric having a laterally projecting fabric appendage for simultaneously facilitating suturing the prosthesis in place and improving tissue infiltration.
Aims: Transcatheter heart valve (THV) implantation in failed bioprosthetic valves (valve-in-valve [ViV]) offers an alternative therapy for high-risk patients. Elevated post-procedural gradients are a significant limitation of aortic ViV. Our objective was to assess the relationship between depth of implantation and haemodynamics. Methods and results: Commercially available THVs used for ViV were included in the analysis (CoreValve Evolut, SAPIEN XT and the Portico valve). THVs were implanted in small surgical valves (label size 19 mm) to simulate boundary conditions. Custom-mounted pulse duplicators registered relevant haemodynamic parameters. Twenty-eight experiments were performed (13 CVE, 5 SXT and 10 Portico). Ranges of depth of implantation were: CVE:-1.2 mm to 15.7 mm;SXT:-2.2 mm to 7.5 mm;Portico: 1.4 mm to 12.1 mm. Polynomial regression established a relationship between depth of implantation and valvular mean gradients (CVE: p,0.001;SXT: p=0.01;Portico: p=0.002), as well as with EOA ...
Boehringer Ingelheim announced that the prescribing information for Pradaxa (dabigatran etexilate mesylate) capsules was updated to include a contraindication related to use in patients with mechanical prosthetic heart valve replacement.
The extent to which Doppler echocardiography information can be used in the assessment of prosthesis hemodynamic performance is still controversial. The goals of our study were to assess the importance of valve design and size both on Doppler echocardiography findings and on pressure recovery in a fluid mechanics model. We performed Doppler and catheter measurements in the different orifices of the bileaflet St Jude (central and side orifices), the monoleaflet Omnicarbon (major and minor orifices), and the stented Biocor porcine prosthesis. Net pressure gradients were predicted from Doppler flow velocities, assuming either independence or dependence of valve size. The peak Doppler estimated gradients (mean +/- SD for sizes 21 to 27) were 21 +/- 10.3 mm Hg for St Jude, 18 +/- 9.3 mm Hg for Omnicarbon, and 37 +/- 14.5 mm Hg for Biocor (P ,.05 for St Jude and Omnicarbon vs Biocor). The pressure recovery (proportion of peak catheter pressure) was 53% +/- 8.6% for central-St Jude, 29% +/- 8. 9% for ...
Synthetic implants made by traditional fabrication routes are not patient specific and rarely match the performance of their biological counterparts. We present an additive manufacturing approach for the digital fabrication of tissue-like aortic heart valves featuring customizable geometry and leaflet architectures that resemble those of native valve tissue... ...Flow was driven by a forward pressure of 100 mmHg imposed across the valve using a pulsatile testing machine (PD2010; ViVitro, Victoria, BC, Canada)... ...The ability to fabricate synthetic implants with tailored designs at multiple length scales is a key contribution toward the digital fabrication of functional implants that perform on par with native body parts.... Go to the Article ...
Aortic root enlargement may be necessary for a small aortic annulus to allow the implantation of a larger aortic valve prosthesis. Larger prostheses are associated with a lower incidence of patient prosthesis mismatch and lower rates of structural valve deterioration. Looking to the future, a larger aortic valve prosthesis will facilitate valve-in-valve aortic replacements by allowing the placement of a larger valve and decreasing the chances of coronary compromise. In this presentation, the authors describe the Nicks procedure, which enlarges the root by extending the aortotomy across the noncoronary sinus through the annulus into the anterior leaflet of the mitral valve.. ...
We describe a case of a 46-year-old woman with dehiscence and paravalvular leak of a second-time replaced mitral mechanical prosthesis, successfully treated with Amplatzer occlusion of the paravalvular leak, thus avoiding a second reoperation and improving the patients symptoms.. ...
TCTMD is produced by the Cardiovascular Research Foundation (CRF). CRF is committed to igniting the next wave of innovation in research and education that will help doctors save and improve the quality of their patients lives. For more information, visit http://www.crf.org.. ...
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 ...