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Valve Selection in End-Stage Renal Disease: Should It Always Be Biological?

Wednesday, August 24, 2016

Submitted by

Arie Blitz

Source

Source Name: Annals of Thoracic Surgery

Source URL: http://www.annalsthoracicsurgery.org/article/S0003-4975(16)30428-3/fulltext

Author(s)

Matthew L. Williams, MD, Joseph E. Bavaria, MD, Michael A. Acker, MD, Nimesh D. Desai, MD, Prashanth Vallabhajosyula, MD, W. Clark Hargrove, MD, Pavan Atluri, MD, Wilson Y. Szeto, MD

This single-center retrospective study evaluated outcomes of ESRD patients undergoing valve surgery based on whether they received either a mechanical or tissue valve. The study spanned the years 2002-2014, and included 64 mechanical and 151 tissue valve replacements. Even after controlling for confounding variables--given the short expected survival in these patients--there is no salutary effect of using a mechanical over a tissue valve.

Comment: Given the morbidity of anticoagulation in, and the shorter lifespan of, ESRD patients, should we be using mechanical valves at all in these patients?