Valve Selection in End-Stage Renal Disease: Should It Always Be Biological? [1]
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?