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

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Reineke, David Christian; Heinisch, Paul Philipp; Winkler, Bernhard Michael; Englberger, Lars and Carrel, Thierry

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0268-4705

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Sara Baumberger

Date Deposited:

09 Mar 2015 14:22

Last Modified:

01 Apr 2016 02:30

Publisher DOI:

10.1097/HCO.0000000000000151

PubMed ID:

25584440

BORIS DOI:

10.7892/boris.64135

URI:

https://boris.unibe.ch/id/eprint/64135

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