Patient-Prosthesis Mismatch After Mitral Valve Replacement Using Bileaflet Preservation Technique for Mitral Regurgitation.

Patient-prosthesis mismatch (PPM) in the mitral valve position is underreported but may occur when both anterior and posterior leaflets are preserved during mitral valve replacement (MVR), a technique that can reduce the area to place an appropriate-size valve. Therefore, balancing the risks and benefits of leaflet preservation is critical, given that certain degrees of left ventricular dysfunction or valvular disease causes may favor bileaflet or partial-leaflet preservation while minimizing the risk for PPM. We report a case of PPM 1 year after MVR with bileaflet preservation in a patient with normal left ventricular size and function who required redo MVR with a larger valve for symptom resolution.