No Difference in Rates of Death, Stroke for Bioprosthetic vs Mechanical Prosthetic Valves

CHICAGO — September 30, 3014 — Among patients aged 50 to 69 years who underwent aortic valve replacement with bioprosthetic or mechanical prosthetic valves, there was no significant difference in 15-year survival or stroke, although patients in the bioprosthetic valve group had a greater likelihood of re-operation but a lower likelihood of major bleeding.
The findings are published in the October 1 issue of JAMA.
In older patients, bioprosthetic valves pose a low lifetime risk of reoperation for structural degeneration and avoid many of the complications associated with mechanical prostheses. Bioprosthetic valves are therefore recommended in patients aged older than 70 years. However, the optimal prosthesis type for younger patients is less clear.
Yuting P. Chiang, Mount Sinai Hospital, New York, New York, and colleagues used a state-wide administrative database to quantify differences in long-term survival, stroke, re-operation, and major bleeding episodes after aortic valve replacement according to prosthesis type.