Valvular & structural heart diseaseCohort study
Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients 40 to 75 Years of Age
- Retrospective cohort study
- inverse probability weighting
- registry-based (STS ACSD)
Authors' conclusion
In patients aged ≤60 years, mechanical AVR was associated with an independent risk-adjusted survival benefit compared with bioprosthetic AVR.
Study context
- Population
- Patients aged 40–75 years undergoing primary isolated surgical aortic valve replacement (AVR), STS ACSD linked to National Death Index, 2008–2019
- Participants
- 109,842 patients
- Exposure
- Mechanical vs bioprosthetic surgical AVR
- Mechanicaln = 15,717
- Bioprostheticn = 94,125reference
- Outcome
- Longitudinal all-cause mortality
Main finding
As reported in the abstract
All-cause mortality (risk-adjusted)
- Freedom from all-cause mortality favored mechanical valves in patients aged 60 years and younger
- Mechanical valves associated with lower all-cause mortality in all age groups ≤60 years
Observational data: associations, not effects.
Further findings
Sensitivity analyses (excluding pure aortic insufficiency, STS predicted risk of operative mortality >4%, discontinued valve types)
- Results consistent across all sensitivity analyses
Original publication
Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients 40 to 75 Years of Age. J Am Coll Cardiol. Published 25 January 2025. doi:10.1016/j.jacc.2025.01.013
Summarised from the published abstract; every number is checked against it