Mechanical Valves Offer Survival Advantage Over Bioprosthetic Valves in Younger Aortic Valve Replacement Patients: JACC
USA: A recent study published in the Journal of the American College of Cardiology has provided valuable insights into the survival outcomes of bioprosthetic versus mechanical aortic valve replacement (AVR) in patients aged 40 to 75 years, offering critical information for patient and healthcare provider decision-making regarding the choice of prosthetic valves.
The researchers revealed that in patients aged 60 years or younger undergoing surgical aortic valve replacement, mechanical valves offer a survival benefit compared to bioprosthetic valves. However, despite this advantage, the use of mechanical valves has been steadily declining, according to the analysis of over 100,000 patients.
Previous observational studies have highlighted the advantages of mechanical valves over tissue valves for middle-aged patients. However, the need for lifelong anticoagulation therapy, along with other concerns, has made these valves less appealing. Additionally, several studies released last year have shown a growing trend of offering transcatheter aortic valve implantation (TAVI) to younger patients. To inform clinical practice, Michael E. Bowdish, Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, and colleagues aimed to assess contemporary, real-world long-term outcomes of aortic valve replacement using data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS-ACSD).
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