Ejection fraction/velocity ratio identifies prosthesis-patient mismatches in patients with aortic bioprosthetic valves and left ventricular dysfunction

Recently, a new echocardiographic nonflow corrected index (ejection fraction/velocity ratio [EFVR] = percent left ventricular ejection fraction [EF]/maximum aortic gradient) has been introduced and has shown excellent accuracy in quantifying the effective orifice area (EOA) in native aortic valves and bio-prostheses. The objective of this study was to assess the utility of the EFVR to quantify the indexed EOA in patients with an aortic bioprosthesis and left ventricular dysfunction considering an indexed EOA value of 0.85 cm(2)/m(2) or less to be indicative of a prosthesis-patient mismatch (PPM), defined as an EOA of the inserted prosthetic valve of less than that of the normal human valve