Different Aortic Valves Linked to Similar Long-Term Survival

No difference seen in mortality, but bioprosthetic valves linked to more failure and reoperation
By Eric Metcalf
HealthDay Reporter

THURSDAY, Nov. 5 (HealthDay News) -- Bioprosthetic (BP) valves for aortic valve replacement have similar longer-term survival rates as mechanical valves (MP), but may carry a higher risk of valve failure and reoperation, according to an Italian study published in the Nov. 10 issue of the Journal of the American College of Cardiology.

Paolo Stassano, M.D., of the University Federico II in Naples, Italy, and colleagues analyzed data from 310 patients undergoing aortic valve replacement who were randomized to receive a BP or MP valve. Patients ranged in age from 55 to 70 years. The outcome measures included reoperation, survival and value failure.

The researchers found that a similar number of patients with BP versus MP value replacements died perioperatively (six versus four). No difference in mortality was seen at 13 years; however, the BP group experienced more valve failures and reoperations. The researchers also showed that both groups experienced the same rate of valve thrombosis, endocarditis and major adverse prosthesis-related events.

"How are the results from this new randomized trial to be incorporated into our management decisions with patients with aortic valve disease who require aortic valve replacement? I think very little has changed," writes the author of an accompanying editorial. "There are no major differences in terms of mortality between the two valve types, but patients receiving a bioprosthetic valve can be assured of developing structural valve deterioration after approximately 10 years and will require reoperation, whereas those patients taking warfarin (primarily the patients receiving a mechanical valve) will likely develop more bleeding."

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