Bioprosthetic and Mechanical Aortic Valves Compared
(HealthDay News) — A new study compares two leading types of aortic valve replacements and finds they have similar performance in terms of long-term risk of stroke and death for patients. The findings were published in the October 1 issue of the Journal of the American Medical Association.
In the new study, researchers led by Yuting Chiang, of Mount Sinai Hospital in New York City, analyzed data from 4,253 patients, aged 50–69, who underwent aortic valve replacement with either a bioprosthetic valve or a mechanical valve.
The researchers found that survival rates after 15 years were 60.6% in the bioprosthetic valve group and 62.1% in the mechanical valve group (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.83–1.14). Stroke rates after 15 years were also similar, at 7.7 and 8.6%, respectively (HR, 1.04; 95% CI, 0.75–1.43). However, the number of patients who required another heart valve operation after 15 years was 12.1% in the bioprosthetic valve group, compared to only 6.9% in the mechanical valve group (HR, 0.52; 95% CI, 0.36–0.75). But mechanical valves had their downside, too – rates of major bleeding after 15 years were 13% in the mechanical valve group, but fell to 6.6% in the bioprosthetic valve group (HR, 1.75; 95% CI, 1.27–2.43).
According to the Mount Sinai researchers, in the "absence of a significant survival benefit associated with one prosthesis type over another," decisions as to which type of valve to implant should be based on other factors, such as how much blood thinning medication the patient might need, and risks for incidents such as bleeding and the need for more surgeries.