Study about Afterload-Mismatch: An Approach to Its Importance in Surgical Decision Making

The present study highlights the hemodynamic loads and their influence on ventricular function. In valvular heart disease, heart failure due to intrinsic myocardial damage causes surgical high mortality. When patient survives surgical time; functional class, deteriorates frequently and intermediate term mortality is also high. On the other hand, when heart failure is due to excessive afterload and normal myocardial structure, the reduction of excessive afterload normalizes ventricular function, reduce surgical mortality and improve long term survival. By incorporating afterload on the evaluation of these patients mortality may be reduced and long term survival significantly improved, just as this case demonstrates. Prospective studies are needed to evaluate optimal cut offs for afterload to predict surgical mortality and long term survival.