Bioprosthetic or Mechanical Surgical Aortic Valve Replacement?

Mechanical AVR was associated with a survival benefit in patients aged ≤60 years.

Balancing the limited durability of bioprosthetic prostheses with the need for oral anticoagulation (OAC) with use of mechanical prostheses leads to complex decision making for younger patients requiring aortic valve replacement (AVR). In this observational study, researchers evaluated survival in 109,842 patients aged 40 to 75 years who received either a bioprosthetic (86%) or mechanical (14%) valve during isolated AVR between 2008 and 2019.

Patients receiving biologic prostheses were older, and the use of mechanical prosthesis decreased from about 20% to 10% during the study period. Median follow-up was 5.4 years, and survival was estimated up to 12 years. After adjustment for differences between the groups, all-cause mortality was lower f…

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)