Key result
Mechanical valves are linked to lower long-term mortality versus biologic prostheses in younger patients.
Why the study?
Does a biologic prosthesis improve long-term mortality compared to a mechanical prosthesis in patients undergoing primary aortic-valve or mitral-valve replacement?
Does a biologic prosthesis improve long-term mortality compared to a mechanical prosthesis in patients undergoing primary aortic-valve or mitral-valve replacement?
Mechanical prostheses are associated with a long-term mortality benefit compared to biologic prostheses up to age 70 for mitral-valve replacement and up to age 55 for aortic-valve replacement.
May favor mechanical valves in select younger patients; leaves open need for randomized confirmation amid evolving bioprostheses.
The long-term mortality benefit that was associated with a mechanical prosthesis, as compared with a biologic prosthesis, persisted until 70 years of age among patients undergoing mitral-valve replacement and until 55 years of age among those undergoing aortic-valve replacement. (Funded by the National Institutes of Health and the Agency for Healthcare Research and Quality.).
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Goldstone et al. (2017) studied this question. Mechanical prostheses provided a long-term mortality benefit compared to biologic prostheses up to 70 years for mitral and 55 years for aortic valve replacement.
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