Why the study?
The choice between mechanical and bioprosthetic valves involves balancing lifelong anticoagulation risks against bioprosthetic degeneration, motivating an evaluation of survival, complications, and reoperation rates after mechanical valve replacement with acenocoumarol, low-dose aspirin, and INR monitoring.
Mechanical valve replacement with appropriate anticoagulation offers favorable long-term survival in younger patients, though women and those with advanced heart failure face higher early postoperative risks.
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Higher survival in men after mechanical valve replacement should not yet change practice; this cohort finding leaves open sex-specific risk validation.
Saksena et al. (2025) studied this question.
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