Impact of Prosthesis-Patient Mismatch on Long-Term Functional Capacity After Mechanical Aortic Valve Replacement

Abstract Background The impact of prosthesis-patient mismatch (PPM) following aortic valve replacement (AVR) for aortic stenosis (AS) on exercise capacity remains controversial. The aim of this study was to analyze the long-term impact of PPM after mechanical AVR on maximal oxygen uptake (VO2max ). Methods The study included 75 patients who had undergone isolated mechanical AVR for AS with normal left ventricular (LV) function between 1994 and 2012. Their functional capacity was evaluated on average 4.6 years post-AVR by exercise testing, including measurement of their VO2max , and by determining their NYHA functional class and SF-36 score. Two groups were defined by measuring the patients’ indexed effective orifice area (iEOA) by transthoracic echocardiography: a PPM group (iEOA