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Protocol for Relative Hydrodynamic Assessment of Tri-leaflet Polymer Valves
Published on: October 17, 2013
Mechanical heart valves in septuagenarians
R Ascione1, L Culliford, C A Rogers
1Bristol Heart Institute, University of Bristol, Bristol, UK. R.Ascione@bristol.ac.uk
Journal of Cardiac Surgery
|February 23, 2008
Summary
Third-generation bileaflet mechanical valves are effective for septuagenarians, showing no increased risk of mortality, bleeding, or thromboembolic events compared to younger patients or biological valves.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Geriatric Medicine
Background:
- Septuagenarians often require aortic valve replacement.
- Mechanical valves offer durability but raise concerns about thrombosis and bleeding.
- Third-generation bileaflet mechanical valves aim to improve hemocompatibility.
Purpose of the Study:
- To evaluate the safety and efficacy of third-generation bileaflet mechanical valves in septuagenarians.
- To compare outcomes in septuagenarians receiving mechanical valves versus younger patients.
- To compare outcomes in septuagenarians receiving mechanical valves versus biological valves.
Main Methods:
- A tertiary regional hospital in South-West England conducted two studies.
- Study 1: 567 patients received Sorin Bileaflet (SB) mechanical valves (130 patients ≥70 years).
- Study 2: 113 septuagenarians received biological valves, matched to the SB septuagenarian group.
Main Results:
- Septuagenarians receiving SB valves had similar in-hospital mortality (2.3%) to younger patients (2.8%) but higher neurological complications (3.8% vs 1.4%).
- Mid-term valve-related mortality at two years was 4.8% in septuagenarians vs 1.8% in younger patients.
- In Study 2, SB valves showed lower in-hospital mortality (1.8% vs 7.1%) and less acute renal failure compared to biological valves in septuagenarians.
Conclusions:
- Third-generation bileaflet mechanical valves demonstrate effective performance in septuagenarians.
- No increased risk of in-hospital mortality, bleeding, or thromboembolic events was observed.
- SB valves appear to be a safe and effective option for selected septuagenarian patients.
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