Bioprosthetic and Mechanical Aortic Valves Compared
Devices have similar results for patient stroke or death, but bioprosthetic valve linked to less bleeding
THURSDAY, Oct. 2, 2014 (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 Oct. 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 to 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 percent in the bioprosthetic valve group and 62.1 percent in the mechanical valve group (hazard ratio [HR], 0.97; 95 percent confidence interval [CI], 0.83 to 1.14). Stroke rates after 15 years were also similar, at 7.7 and 8.6 percent, respectively (HR, 1.04; 95 percent CI, 0.75 to 1.43). However, the number of patients who required another heart valve operation after 15 years was 12.1 percent in the bioprosthetic valve group, compared to only 6.9 percent in the mechanical valve group (HR, 0.52; 95 percent CI, 0.36 to 0.75). But mechanical valves had their downside, too -- rates of major bleeding after 15 years were 13 percent in the mechanical valve group, but fell to 6.6 percent in the bioprosthetic valve group (HR, 1.75; 95 percent CI, 1.27 to 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.