Matkovic, Milos (57113361300)Milos (57113361300)MatkovicAleksic, Nemanja (57209310510)Nemanja (57209310510)AleksicBilbija, Ilija (57113576000)Ilija (57113576000)BilbijaAntic, Ana (57224966433)Ana (57224966433)AnticLazovic, Jelena Milin (6507693272)Jelena Milin (6507693272)LazovicCubrilo, Marko (57209307258)Marko (57209307258)CubriloMilojevic, Aleksandar (57219864196)Aleksandar (57219864196)MilojevicZivkovic, Igor (57192104502)Igor (57192104502)ZivkovicPutnik, Svetozar (16550571800)Svetozar (16550571800)Putnik2025-06-122025-06-122023https://doi.org/10.14503/THIJ-22-8048https://www.scopus.com/inward/record.uri?eid=2-s2.0-85175266601&doi=10.14503%2fTHIJ-22-8048&partnerID=40&md5=40a9567ce842b9be9ae4a88fc225e753https://remedy.med.bg.ac.rs/handle/123456789/2544Background: Patient-prosthesis mismatch (PPM) may impair functional capacity and survival after aortic valve replacement. This study aimed to investigate the impact of PPM on long-term survival and quality of life after mechanical and biological aortic valve replacement. Methods: This study included 595 consecutive patients who had undergone isolated aortic valve replace-ment. Patients were divided into 2 groups according to prosthesis type. The baseline and operative charac-teristics, survival rates, complications, and quality of life of the groups with and without PPM were compared for up to 6 years. The PPM calculation was performed using the effective orifice area value provided by the manufacturer divided by the patient’s body surface area. Results: The moderate to severe PPM rates were 69.8% and 3.7% after biological and mechanical prosthesis implantation, respectively. Mean survival for patients in the biological group who had PPM was statistically significantly shorter (50.2 months [95% CI, 45.2-55.3]) than for patients in the biological group without PPM (60.1 months [95% CI, 55.7-64.4]; P = .04). In the mechanical prosthesis group, there was no difference in mean survival between the subgroup with PPM (66.6 months [95% CI, 58.3-74.9]) and the subgroup without PPM (64.9 months [95% CI, 62.6-67.2]; P = .50). A quality-of-life questionnaire’s scores did not differ between the groups. Conclusion: Mismatch is common after biological valve implantation and statistically significantly affects long-term survival and quality of life. If the risk of PPM after implantation of a biological prosthesis is sus-pected, adopting strategies to avoid PPM at the time of surgery is warranted. © 2023, Texas Heart Institute. All rights reserved.aortic valve diseasebioprosthesisheart valve prosthesis implantationPatient outcome assessmentquality of life