Valvular & structural heart diseaseCohort study
Durability of Bioprosthetic and Mechanical Valves Implanted for Aortic Valve Replacement in Pediatric Patients
- Retrospective review of surgical aortic valve replacement (AVR) procedures
- propensity-score-adjusted analysis
Authors' conclusion
In pediatric patients undergoing AVR, bioprosthetic valves have significantly worse durability than mechanical prostheses, with the disparity most pronounced in younger patients. Valve-related mortality and complications were relatively common. These findings should focus attention on the need for better replacement valves or therapeutic options in young patients with aortic valve disease.
Study context
- Population
- Patients ≤21 years of age undergoing surgical AVR with a mechanical valve or bioprosthesis, May 2002 to July 2024AVR procedures (median age, 14.3 years)
- Participants
- 180 patients
- Exposure
- Bioprosthetic valve vs mechanical valve for AVR
- bioprosthetic valven = 79
- mechanical prosthesisn = 101
Main finding
As reported in the abstract
5 years
10 years
- bioprosthetic valve vs mechanical prosthesis: P < 0.001 — significantly shorter with bioprosthetic valve
Observational data: associations, not effects.
Further findings
Shorter freedom from reintervention (propensity score-adjusted multivariable Cox regression)
| Comparison | Hazard ratio | P value | |
|---|---|---|---|
| bioprosthetic valve · propensity score-adjusted | 4.66 (95% CI 2.26–9.62) | P < 0.001 | |
| age <12 years at AVR · propensity score-adjusted | 3.26 (CI 1.81–5.87) | P < 0.001 | |
| 0.10.31310Hazard ratio (log scale) |
Safety
Endocarditis
- patients diagnosed with endocarditis
- 16
Thromboembolic or bleeding complications
- patients with thromboembolic or bleeding complications
- 8
Original publication
Summarised from the published abstract; every number is checked against it