Valvular & structural heart disease
Progressive Left Ventricular (LV) Dysfunction and Adverse Outcomes After Aortic Valve Replacement With Bioprosthetic Valves in Young Patients
Authors' conclusion
AVR with a bioprosthetic valve was associated with progressive LV hypertrophy and dysfunction, and worsening clinical status compared with mechanical prosthetic valves. This provides further evidence against the use of bioprosthetic AVR in young patients.
Study context
- Population
- Adults with congenital heart disease who underwent aortic valve replacement (AVR) at Mayo Clinic (2003–2023)151 Bio_AVR and 302 Mech_AVR patients
- Participants
- 151 vs 302
- Exposure
- AVR with bioprosthetic valves versus mechanical prosthetic valves
- Bio_AVR groupn = 151
- Mech_AVR groupn = 302
- Outcome
- LV and clinical indices
- Follow-up
- Baseline and 1 year post-AVR
Methodological detailsmatched 1:2, single-centre (Mayo Clinic)
- Matched 1:2
- Single-centre (Mayo Clinic)
Main finding
As reported in the abstract
- Both groups had similar LV and clinical indices at baseline and 1 year post-AVR
Observational data: associations, not effects.
Further findings
LV mass index, relative wall thickness, averaged E/e′, averaged e′, LV global longitudinal strain · 5 and 10 years post-AVR
- Bio_AVR group had higher LV mass index, relative wall thickness, and averaged E/e′, and lower averaged e′ and LV global longitudinal strain
LV and clinical indices after second AVR (Bio_AVR group)
- Of 51 patients from the Bio_AVR group who underwent a second AVR, less robust improvement in LV indices and clinical indices after the second AVR compared with the first AVR
Original publication
Progressive LV Dysfunction and Adverse Outcomes After Aortic Valve Replacement With Bioprosthetic Valves in Young Patients. Circ Cardiovasc Imaging. Published 3 April 2025. doi:10.
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