Mitral valve replacement in patients under 65 years of age: mechanical or biological valves?

Reineke, David Christian; Heinisch, Paul Philipp; Winkler, Bernhard Michael; Englberger, Lars; Carrel, Thierry (2015). Mitral valve replacement in patients under 65 years of age: mechanical or biological valves? Current opinion in cardiology, 30(2), pp. 146-150. Lippincott Williams & Wilkins 10.1097/HCO.0000000000000151

Preview

Text 00001573-201503000-00004.pdf - Published Version Available under License Publisher holds Copyright. Download (187kB) | Preview

PURPOSE OF REVIEW

There is controversy regarding the optimal choice of prosthetic valves in patients less than 65 years of age requiring mitral valve replacement (MVR). Recently, trends for valve replacement are moving towards biological prosthesis also in younger patients, which is justified by the fact that a later valve-in-valve procedure is feasible in the case of degeneration of the tissue valve. This strategy is increasingly recommended in aortic valve surgery but is questionable for MVR. The purpose of this review is to evaluate current guidelines and analyse evidence for biological MVR in patients under 65 years.

RECENT FINDINGS

There are differences between guidelines of the American Heart Association and those of the European Society of Cardiology concerning the choice of prostheses in patients undergoing MVR. Although the European Society of Cardiology recommends a mechanical mitral valve in patients under 65 years of age, the American Heart Association does not provide detailed advice for these patients. Mitral valve replacement with biological valves in patients under 65 years is associated with higher rates of reoperation due to structural valve deterioration. In addition, several studies showed a decreased survival after biological MVR.

SUMMARY

Evidence for biological MVR in patients less than 65 years without comorbidities or contraindication for oral anticoagulation does not exist. Recommendations for patients less than 65 years of age should not be blurred by current 'en-vogue' methods for promising but not yet proven valve-in-valve strategies.

Interest & Impact

Downloads

427 since deposited on 09 Mar 2015
43 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item