Bioprosthetic vs. Mechanical Aortic Valve Replacement in Younger Patients

The two valve types are associated with similar mortality but different risks for bleeding and reoperation.

The optimal prosthesis for patients younger than 70 who need aortic valve replacement (AVR) is controversial. In this retrospective analysis of the New York State database of >4000 patients aged 50 to 69 years who had a first AVR between 1997 and 2004, investigators used propensity-score matching to identify 1001 patient pairs to compare bioprosthetic and mechanical valve replacement.

The actuarial 15-year survival (median, 10.9 years) was similar in the bioprosthetic group (61%) and in the mechanical prosthesis group (62%; hazard ratio, 0.97). The rate of stroke was also similar (about 8% in both groups). However, aortic valve reoperation was more frequent after bioprostheses (12.1% vs. 6.9%), whereas major bleeding was more frequent with m…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)