Key result
Aortic tissue valves match mechanical valves for thromboembolism but are linked to less anticoagulation-related bleeding.
Why the study?
Guidance is needed to select between mechanical and tissue heart valves due to differences in durability, anticoagulation requirements, and complication risks.
Do mechanical heart valves compared to tissue heart valves reduce complications in patients requiring heart valve replacement?
Do mechanical heart valves compared to tissue heart valves reduce complications in patients requiring heart valve replacement?
Mechanical and tissue valves have equivalent thromboembolism rates, and while aortic tissue valves have lower bleeding risk, mitral tissue and mechanical valves have equivalent bleeding risks.
Aortic tissue valves may lower bleeding without raising thromboembolism; leaves open mitral comparisons and randomized confirmation before practice change.
This review provides general guidance for heart valve selection. Mechanical heart valves exhibit excellent durability and hemodynamic performance but require anticoagulation to reduce thromboembolism, and therefore risk of anticoagulation-related hemorrhage is increased. Tissue valves were introduced to avoid anticoagulation, but in fact often do not, and lack durability. A literature review was performed to compare the complications of thromboembolism, anticoagulation-related hemorrhage, reoperation structural valve deterioration, and reoperative mortality associated with mechanical and tissue valves. The thromboembolism rates for mechanical and tissue valves are equivalent. During their lives, many recipients of tissue valves receive anticoagulation therapy due to comorbid conditions. The anticoagulation-related blood loss rates associated with mitral mechanical valves and mitral tissue valves are equivalent, whereas the blood loss rates associated with aortic tissue valves are less than those associated with aortic mechanical valves.
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Steven J. Phillips (2004) conducted a review in Heart valve disease. Mechanical heart valves vs. Tissue heart valves was evaluated on Thromboembolism, anticoagulation-related hemorrhage, structural valve deterioration, and reoperative mortality. Mechanical and tissue heart valves have equivalent thromboembolism rates, while aortic tissue valves are associated with lower anticoagulation-related blood loss than aortic mechanical valves.
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