Procedures and Outcomes of Surgical Aortic Valve Replacement in Adults | Mitral Valve Repair Center Skip to main content

Amine Mazine, MD, Ismail El-Hamamsy, MD

Feb. 01, 2020 | Cardiology Clinics

The ideal aortic valve substitute remains elusive. Bioprosthetic valves are the replacement option of choice in elderly patients undergoing aortic valve replacement (AVR). When implanted in young and middle-aged adults, both bioprosthetic and mechanical valves are associated with excess mortality compared with the age- and sex-matched general population. The Ross procedure is the only operation that can restore normal life expectancy in young and middle-aged adults undergoing AVR. In this article, the authors review the various options for surgical AVR and examine their contemporary applications and outcomes.

Key points

  • Although in elderly patients, bioprosthetic valves are durable and associated with low rates of valve-related complications, in non-elderly adults, they are associated with reduced durability and lower than expected survival, both of which are worsened by the presence of patient-prosthesis mismatch.
  • In young adults, mechanical valves are associated with lower rates of prosthesis degeneration and need for reoperation compared with bioprosthetic valves, at the cost of higher rates of anticoagulation-related bleeding and thromboembolic events.
  • Nevertheless, both mechanical and bioprosthetic valves are associated with excess mortality compared with the general population when implanted in non-elderly patients.
  • The Ross procedure is the only operation that can restore a normal life expectancy in young and middle-aged adults undergoing aortic valve replacement.
Page Created: Mar. 18, 2021 Last Updated: Mar. 24, 2021

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