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Updated: Jun 2, 2026
Bioelectric Analyses of an Osseointegrated Intelligent Implant Design System for Amputees
Published on: July 15, 2009
Biological versus mechanical prosthesis in 3279 patients from the Swedish in-patients register
Laila Hellgren1, Fredrik Granath, Anders Ekbom
1Department of Cardiothoracic Surgery, University Hospital, Uppsala, Sweden. laila.hellgren.johansson@akademiska.se
Objectives:
To compare valve-related morbidity among patients aged < 70 and ≥ 70 years, receiving either a mechanical or a biological prosthesis in a population-based setting.
Design:
In total, 3279 patients (21 644 patient-years) were followed up through the Swedish National In-Patients Register, which registers all hospital admissions. Death, thromboembolism, bleeding, endocarditis, valve thrombosis and reoperations were all captured.
Results:
Survival was lower among patients aged <70 years with a bioprosthesis compared to a mechanical prosthesis (p < 0.0001), but equal among older patients. A mechanical prosthesis indicated a lower risk (p < 0.001) of thromboembolism (1.5% per patient year, ppy), than bioprosthesis (2.6% ppy), irrespective of age. Bleeding was increased (p = 0.002) with a mechanical prosthesis (1.7% ppy) compared to a bioprosthesis (1.1% ppy); the risk of bleeding increased early (<5 years) whereas thromboembolism increased late (>5 years). Event-free survival was higher in younger patients with a mechanical prosthesis compared to bioprosthesis recipients (p < 0.001), but equal among older patients.
Conclusions:
Survival was comparable in older patients irrespective of prosthesis type. Bleeding was increased with a mechanical prosthesis, especially in the elderly. The risk of thromboembolism was higher in patients with a bioprosthesis.
