Key result
Mechanical valves linked to ~18% lower 15-year mortality versus bioprostheses in AVR patients aged 50-69.
Why the study?
Evidence is mixed and American and European guidelines differ regarding the most appropriate type of valve prosthesis for surgical AVR in patients aged 50 to 69 years.
Does a mechanical valve improve survival compared to a Perimount bioprosthesis in patients aged 50 to 69 years undergoing surgical aortic valve replacement?
Observational (n=6,907)
Yes
Does a mechanical valve improve survival compared to a Perimount bioprosthesis in patients aged 50 to 69 years undergoing surgical aortic valve replacement?
Effect estimate: survival difference -7.9% (95% CI -11% to -4.6%)
Absolute Event Rate: 37% vs 45%
In patients aged 50 to 69 years undergoing surgical AVR, mechanical valves were associated with a significant long-term survival advantage compared to Perimount bioprostheses, despite a higher bleeding risk.
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May inform valve selection in 50-69 year olds; leaves open causal confirmation in randomized trials.
Lu et al. (2023) conducted an observational in Surgical aortic valve replacement (n=6,907). Mechanical valve vs. Perimount bioprosthetic valve was evaluated on All-cause mortality (survival difference -7.9%, 95% CI -11% to -4.6%). Mechanical valves were associated with lower 15-year all-cause mortality compared to Perimount bioprostheses in patients aged 50 to 69 years undergoing surgical AVR (37% vs 45%; survival difference -7.9%, 95% CI -11% to -4.6%).
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