The impact of prosthesis–patient mismatch after aortic valve replacement varies according to age at operation

The objective of this study was to investigate whether the consequences of patient prosthesis mismatch (PPM) following aortic valve replacement (AVR) differ according to patient age. The authors hypothesised that in older patients (aged 70 and above) the implications of PPM may be less important due to lower baseline physical function and competing mortality risks. This single centre study included 707 patients who underwent first-time AVR with follow-up out to 17.5 years. The incidence of PPM was 68% in patients aged 70 or older compared to 26% in patients aged less than 70. The authors found that in patients aged less than 70 with left ventricular dysfunction PPM was associated with reduced survival and increased congestive heart failure. Post-operative left ventricular mass regression was impaired in older patients in general and in those with PPM aged 70 or over with left ventricular dysfunction.