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August 28, 2023Frontiers in Cardiovascular MedicineOpen Access

Trends in SAVR with biological vs. mechanical valves in middle-aged patients: results from a French large multi-centric survey

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Why the study?

Biological prosthetic valves are increasingly chosen over mechanical valves for SAVR across all adult ages despite durability concerns, leaving the real-world patterns relative to patient age and implant time to be assessed.

What are the temporal trends in the use of biological versus mechanical valves for SAVR across different age groups?

Population

72,375 SAVR patients from 22 French public or private centers

Comparison

Mechanical vs biological valve prostheses

Design

Multicenter national database survey

Authors

TCThierry CausYCYuthiline ChabryJNJoseph Nader

Discussion

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Overview

Observed divergence from guidelines in younger SAVR patients should not yet change practice; leaves open need for prospective outcome data.

Structured PICO

What are the temporal trends in the use of biological versus mechanical valves for SAVR across different age groups?

P
Population
72,375 patients undergoing surgical aortic valve replacement (SAVR) from 2007 to 2022 across 22 centers in France, mean age 71.4 years. Excluded: patients with associated pathology of the aorta (aneurysm or dissection) requiring a vascular aortic prosthesis.
I
Intervention
Biological valve prosthesis for SAVR
C
Comparator
Mechanical valve prosthesis for SAVR
O
Outcome
Mechanical vs. biological prosthesis ratio (MBPR) relative to patient's age and implant time

Real-world data from France demonstrates a recent shift towards using biological rather than mechanical valves for SAVR in younger patients (50-60 years old), diverging from contemporary guideline recommendations.

Cite This Study

Caus et al. (2023) studied this question.

synapsesocial.com/papers/6a8be58f62f3e950e68b95e1https://doi.org/10.3389/fcvm.2023.1205770
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Trend and early outcomes in isolated surgical aortic valve replacement in the United Kingdom2023 · 15 citations
  2. 2Early and Late Outcomes of Aortic Valve Replacement Using Bioprosthetic Versus Mechanical Valve in Elderly Patients: A Propensity Analysis2016 · 22 citations
  3. 3Survival and Long-term Outcomes Following Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients Aged 50 to 69 Years2014 · 329 citations
  4. 4Aortic valve replacement with mechanical vs. biological prostheses in patients aged 50–69 years2015 · 291 citations
  5. 5Endocarditis risk with bioprosthetic and mechanical valves: systematic review and meta-analysis2020 · 52 citations