Comparison of the Long-Term Outcomes of Mechanical and Bioprosthetic Aortic Valves　― A Propensity Score Analysis ―

Abstract

of age, either type of valve prosthesis can be chosen. The aim of this study was to assess the mortality and valverelated complications and compare the long-term outcomes of mechanical vs. bioprosthetic valves in Japanese patients undergoing aortic valve replacement (AVR) stratified into 3 age groups (<60 years; 60-69 years, and ≥70 years). Methods PatientsThis study was a pooled analysis of 2 large retrospective T he American College of Cardiology/American Heart Association (ACC/AHA) recently published their revised guidelines on the selection of prosthetic valves. 1 According to their class I recommendation, patient values and preferences must be taken into account, based on full disclosure and understanding of the indications for anticoagulant therapy and the potential need for and risk of reoperation. Besides patient preference, age has been one of the most important factors influencing prosthetic valve choice: mechanical valves are recommended for patients <60 years of age, and bioprosthetic valves for those >70 years of age. For those between 60 and 70 years Background: The aim of this study was to assess the long-term outcomes of aortic valve replacement (AVR) with either mechanical or bioprosthetic valves according to age at operation.

Intermediate-term outcomes of aortic valve replacement with bioprosthetic or mechanical valves in patients on hemodialysis

“…One of the greatest merits of mechanical valves is greater freedom from reoperation, especially in younger patients. [29][30][31] In contrast, reoperation due to SVD in bioprosthetic valves is always a concern. In this study, we found that the incidence of SVD in bioprosthetic valves was only 2.0% in patients on hemodialysis, and the reoperation rate due to SVD and other reasons among patients on hemodialysis was not particularly high at approximately 2% to 3% within 5 years of surgery in both group M and group B.…”

Aortic valve replacement in patients aged 50 to 69 years: Analysis using Korean National Big Data

“…AVR, aortic valve replacement AVR with mechanical valves compared to those with bioprosthetic valves. 8,[10][11][12][17][18][19] In the present study, there were no differences between the two groups in survival as well as cardiac mortality-free survival. No significant differences were found in overall survival as well as cardiac mortality-free survival between patients who underwent AVR with biological prosthesis and mechanical prosthesis in the present study.…”

“…Several studies also have revealed mechanical valves to be superior to bioprosthetic valves in terms of survival in these aged group of patients 5,9,13,14,16 . Other studies, however, have failed to demonstrate superiority in terms of survival in the patients who underwent AVR with mechanical valves compared to those with bioprosthetic valves 8,10–12,17–19 …”

Bioprosthetic aortic valve replacement: a telltale from the young

“…On the other hand, in the Edinburgh trial, Oxenham et al (5) conducted a prospective randomized study in which they found no differences in the 20-year survival rate between mechanical and bioprosthetic valves. Similarly, McClure et al (6) and Minakata et al (7) reported that there was no difference in overall survival between the two types of valves. In contrast, with the slightly controversial statement regarding the survival, it seems that there is an agreement of most of the studies that the major bleeding events are more common in MVs.…”