Key result
In a microsimulation model for a 65-year-old male without CABG, mechanical valves compared to bioprostheses yielded a lifetime risk of valve-related events of 51% vs 47%.
Why the study?
Does the choice of mechanical valve versus bioprosthesis affect life expectancy and event-free life expectancy in patients undergoing AVR with or without CABG?
Population
13,281 patients undergoing primary aortic valve replacement
Comparison
Mechanical valves for AVR vs Stented porcine bioprostheses for AVR
Design
Meta-analysis
Follow-up
79,877 patient-years total
Authors
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May support lowering bioprosthesis threshold to ~60 years for AVR; extends microsimulation evidence irrespective of concomitant CABG.
Meta-Analysis (n=13,281)
Yes
Does the choice of mechanical valve versus bioprosthesis affect life expectancy and event-free life expectancy in patients undergoing AVR with or without CABG?
Absolute Event Rate: 51% vs 47%
The recommended age threshold for using a bioprosthesis instead of a mechanical valve for AVR could be lowered to around 60 years, irrespective of whether the patient requires concomitant CABG.
Puvimanasinghe et al. (2003) conducted a meta-analysis in Aortic valve replacement (AVR) with or without CABG (n=13,281). Mechanical valves vs. Stented porcine bioprostheses was evaluated on Lifetime risk of at least one valve-related event (for a 65-year-old male without CABG). In a microsimulation model for a 65-year-old male without CABG, mechanical valves compared to bioprostheses yielded a lifetime risk of valve-related events of 51% vs 47%.
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