Patients aged between 40 and 70 years that need replacement of their aortic valves may benefit from bioprosthetic (donor tissue) valves rather than mechanical (metal) valves.
People that need aortic valve replacement (AVR) can choose between the two mentioned types of replacement. Both valves show equal mortality and morbidity rates 15 years post-surgery. However, each prosthetic valve has his own pros and cons. Bioprosthetic valves degrade slowly and often need replacement after some years. Mechanical valves on the contrary, should function properly for the rest of the patient’s life. A huge disadvantage of mechanical valves, however, is that blood clots easily form on the valve. For this reason, the patient must take anticoagulants for the rest of his life. These anticoagulants are associated with a higher risk of massive bleeding, since the normal blood clotting cascade is suppressed.
Researchers found that such massive, uncontrollable bleedings carry a higher mortality rate compared to bioprosthetic valve replacement. For this reason, it is recommended for patients between the ages 40 and 70 to strongly consider bioprosthetic valves, rather than mechanical valves.
However, this remains a difficult decision. Ideally, a discussion with both the surgeon and the cardiologist is warranted to take into account an individual’s circumstances.
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