Patient-Prosthesis Mismatch (Indexed Effective Orifice Area)

Patient-prosthesis mismatch, graded by the indexed effective orifice area: EOAi = prosthesis effective orifice area (cm2) divided by patient body surface area (m2).

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Valve position
Mitral
Prosthesis effective orifice area
1.6 cm^2
Patient body surface area
2.0 m^2

Result: EOAi 0.80 cm2/m2, severe mismatch.

The tool opens with these values already filled in. Replace them with your own.

What the result means

Aortic
Above 0.85 not clinically significant; 0.65 to 0.85 moderate; below 0.65 severe.
Mitral
Above 1.2 not clinically significant; above 0.9 to 1.2 moderate; 0.9 or below severe. An EOAi of 1.0 is normal aortic and moderate mitral.
Boundary
The cited aortic source defines severe as below 0.65; later tables define it as 0.65 or below.
Scope
A hemodynamic relationship, not prosthesis failure, not a prediction, and not an indication for reoperation.

What you enter

  • Valve position.
  • Prosthesis effective orifice area.
  • Patient body surface area.
Full field descriptions
  • Valve position. REQUIRED and never assumed - the thresholds are not interchangeable, and an EOAi of 1.0 is normal aortic but moderate mitral [aortic = Aortic, per Pibarot and Dumesnil, Heart 2006; mitral = Mitral, per Magne and colleagues, Circulation 2007]
  • Prosthesis effective orifice area. Use the MEASURED or REFERENCE effective orifice area, not the labelled valve size, which is a manufacturing dimension and overstates the opening.
How this is calculated
Formula
EOAi = prosthesis effective orifice area divided by body surface area. Use the measured or reference EOA, not the labelled size.

Pibarot P, Dumesnil JG. Prosthesis-patient mismatch: definition, clinical impact, and prevention. Heart. 2006;92(8):1022-1029 (aortic). Mitral grading: Magne J, et al. Circulation. 2007;115(11):1417-1425. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.