Bioprosthetic or mechanical heart valves: prosthesis choice for borderline patients?—Results from 9,616 cases recorded in Polish national cardiac surgery registry
Key result
In patients aged 60-70 years undergoing aortic valve replacement, the use of bioprosthetic valves increased significantly from 22.5% in 2006 to 76.8% in 2016 (P<0.001).
Why the study?
Current guidelines do not unequivocally recommend bioprosthetic or mechanical prostheses for middle-aged patients aged 60–70 years undergoing AVR, leaving prosthesis selection complex.
What are the trends and predictors of bioprosthetic versus mechanical valve selection in patients aged 60-70 years undergoing isolated AVR?
Population
9,616 patients aged 60–70 years undergoing isolated AVR in Poland
Comparison
Bioprosthetic vs mechanical heart valves
Design
National cardiac surgery registry-based study
Authors
Discussion
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Member takes
Implication
Marked shift toward bioprosthetic valves in 60-70 year olds; leaves open questions on durability, reintervention, and long-term outcomes.
Study Design
Type
Observational (n=9,616)
Multicenter
Yes
Structured PICO
What are the trends and predictors of bioprosthetic versus mechanical valve selection in patients aged 60-70 years undergoing isolated AVR?
P
Population
9,616 consecutive patients aged 60-70 years who underwent isolated aortic valve replacement across all cardiac surgery departments in Poland between 2006 and 2016.
E
Exposure
Bioprosthetic valve implantation
C
Comparator
Mechanical valve implantation
O
Outcome
Trends in AVR prosthesis selection over a 10-year period and predictors of mechanical valve implantation
Main Result
Absolute Event Rate: 76.8% vs 22.5%
p-value: p=<0.001
Real-world registry data from Poland demonstrates a dramatic shift toward bioprosthetic valves over mechanical valves for isolated AVR in borderline patients aged 60-70 years, rising from 22.5% in 2006 to 76.8% in 2016.
Cite This Study
Bartuś et al. (2020) conducted an observational in Aortic valve replacement (n=9,616). Bioprosthetic heart valves vs. Mechanical heart valves was evaluated on Proportion of bioprosthetic valves implanted in 2016 vs 2006 (p=<0.001). In patients aged 60-70 years undergoing aortic valve replacement, the use of bioprosthetic valves increased significantly from 22.5% in 2006 to 76.8% in 2016 (P<0.001).