Comparison of mechanical and bioprosthesis valve in over 70-year-old patients with aortic valve replacement: mechanical & bioprosthesis valve

Abstract

INTRODUCTION: Postoperative early and midterm results of mechanical valve were compared with bioprosthetic valve in patients over 70 years old who underwent aortic valve replacement (AVR) and/or coronary artery bypass graft (CABG). METHODS: Demographic data, valve number, New York Heart Assosiation (NYHA) classification, ejection fraction (EF), operative and postoperative early and midterm results were investigated. Postoperatively NYHA, hemorrhage, peripheral embolism, and warfarin use and echocardiography parameters were compared statistically between bioprosthetic valve and mechanical valve. RESULTS: There were 28 patients in mechanical valve group and 9 patients in bioprosthetic valve group. No statistically difference was found between two groups in terms of operative and postoperative early term results. Control echocardiographic comparison revealed that the valve area of mechanical valves was significantly narrower than that of bioprosthetic valves (p=0,047). According to long-term results, one of the patients with mechanical valve died from cerebral hemorrhage due to OAC (oral anticoagulant); 2 cases had bleeding and 3 cases had peripheral embolism. It has been learned that 3 mechanical prosthesis patients with KABG + AVR and one bioprosthesis patient have lost due to heart failure in late term period. DISCUSSION AND CONCLUSION: When the most important disadvantage of the bioprosthetic valve is early degeneration, mechanical valve's is the use of OAC. The superiority of the two groups in terms of operative and postoperative early periods could not be demonstrated. In the mid-term, echocardiography showed that bioprosthetic valves provide a better orifice area. The main factor responsible for mortality is left ventricular dysfunction and old age. In order to detect degenerative changes in the bioprosthesis valve, it may be necessary to follow them more over 5-7 years.

Keywords

• aortic valve replacement
• mechanical valve
• bioprosthetic valve
• mortality
• morbidity