Abstract
Patient prosthesis mismatch is undesirable and continues to be a controversial topic since the beginning of aortic valve replacement. The major issue with patient prosthesis mismatch is the effective orifice area: all valve prostheses except stentless bioprostheses had a significantly smaller effective orifice area than the normal native valve. Therefore, in many patients with prosthetic heart valves, left ventricular outflow obstruction improved from severe to moderate [1], but a pathologic transprosthetic pressure gradient remains.
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