Bryan's Journal

When a heart valve is severely damaged and cannot be reliably repaired our best option is a replacement. Let's talk about the “spare parts” available to us.

Middle-aged heart valve replacement patients may have better outcomes if they receive valves made from animal tissue rather than metal, researchers report. The

The current American Heart Association and American College of Cardiology (AHA/ACC) guidelines recommend that biologic valves are reasonable in patients aged 70 or above (Class IIa recommendation), whereas a mechanical valve is reasonable for patients below 60 years of age (Class IIa recommendation) 1. While the guidelines make clear that patient choice and willingness to take anticoagulation should be the major factor in deciding valve choice, these two recommendations reflect the dominating dichotomy in surgical valve replacement – young patients preferentially receive mechanical valves while older patients receive biologic valves. We provide the rationale for consideration of biologic valves as a primary choice for aortic valve replacement in adults below 70 years of age. Majority of data on biologic aortic valve replacement derives from studies of stented porcine and pericardial valves – we limit this discussion to these valve types. Separate considerations may apply to other biologic valve choices including stentless xenografts, and human valves (autografts and allografts).