March 28, 2017European Heart JournalOpen Access

Mechanical aortic valve replacement in non-elderly adults: meta-analysis and microsimulation

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Population

5,728 non-elderly adults from 29 publications undergoing aortic valve replacement, with study mean age…

Design

Meta-analysis

Follow-up

pooled mean 5.7 years

Authors

NKNelleke M. KortelandLeiden University Medical Center JEJonathan R.G. EtnelErasmus MC BABardia ArabkhaniLeiden University Medical Center

Discussion

Member takes

Implication

Suboptimal survival after mechanical AVR in non-elderly adults warrants caution in prosthesis selection; leaves open optimal choice for this population.

Structured PICO

Population

5,728 non-elderly adults from 29 publications undergoing aortic valve replacement, with study mean age inclusion criteria of ≥18 and ≤55 years (pooled mean age 48.0 years).

Intervention

Aortic valve replacement (AVR) with bileaflet mechanical valves

Outcome

Clinical outcomes including early mortality, late mortality, thromboembolism, major bleeding, nonstructural valve dysfunction, endocarditis, valve thrombosis, structural valve deterioration, and reinterventionhard clinical

Mechanical aortic valve replacement in non-elderly adults is associated with suboptimal long-term survival and substantial lifetime risks of anticoagulation-related complications and reoperation, highlighting the need for shared decision-making when selecting prosthetic valves.

Cite This Study

Korteland et al. (2017) studied this question.

synapsesocial.com/papers/6a6fa4fc5d37378ac1dcb404 https://doi.org/10.1093/eurheartj/ehx199

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Implication

Suboptimal survival after mechanical AVR in non-elderly adults warrants caution in prosthesis selection; leaves open optimal choice for this population.