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Updated: Aug 6, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Biological versus mechanical prostheses for aortic valve replacement
Emiliano A Rodríguez-Caulo1, Oscar R Blanco-Herrera2, Elisabet Berastegui3
1Cardiovascular Surgery Department, Virgen de la Macarena University Hospital, Sevilla, Spain.
For patients aged 50-65 undergoing aortic valve replacement, long-term survival was similar between biological and mechanical prostheses. Mechanical valves increased bleeding risk, while biological valves had higher reoperation rates.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
Background:
- Aortic valve replacement (AVR) decisions require long-term outcome data.
- Choosing between biological (Bio) and mechanical (Mech) prostheses is critical for patients aged 50-65.
Purpose of the Study:
- To compare long-term survival and major adverse cardiac and cardiovascular events (stroke, reoperation, major bleeding) for Bio vs. Mech prostheses in AVR patients aged 50-65.
Main Methods:
- Multicenter observational study (2000-2018) of 5215 patients with severe isolated aortic stenosis.
- 15-year follow-up with 2:1 propensity score matching (1822 Mech, 911 Bio).
- Competing risks analyses were applied.
Main Results:
- No significant difference in long-term survival between Bio and Mech prostheses.
- Mechanical prostheses showed a trend towards higher stroke risk (P=0.07).
- Higher rates of major bleeding with Mech prostheses (P=0.004); higher reoperation rates with Bio prostheses (P<0.001).
Conclusions:
- Long-term survival is comparable for Bio and Mech prostheses in the 50-65 age group.
- Mech prostheses are associated with increased bleeding risk; Bio prostheses with higher reoperation risk.
- Biological prostheses represent a reasonable choice for AVR in this patient demographic in Spain.
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