Bioprosthetic Versus Mechanical Surgical Aortic Valve Replacement in Patients ≥65 Years of Age

This retrospective study evaluated the longitudinal outcomes of bioprosthetic (bAVR) versus mechanical surgical aortic valve replacement (mAVR) in Medicare beneficiaries aged 65 years old and older (n=69,423). After risk adjustment, the authors found that bAVR was associated with superior five-year freedom from the primary composite outcome (i.e., stroke, hemorrhage, reintervention, or death; HR=0.82) and significantly reduced longitudinal all-cause mortality (HR=0.78) compared to mAVR. Furthermore, bAVR yielded markedly lower readmission rates for bleeding (HR=0.47) without increasing mid-term valve reinterventions. Thus, the authors concluded that bAVR confers a distinct survival and morbidity advantage, substantiating its preferential utilization over mechanical prostheses in elderly patients.