Primary aortic valve replacement in adults from age 45 to 65 and how their survivability, post replacement, may be affected by opting for a bioprosthetic or mechanical valve.

Abstract: Introduction: Aortic valve replacement in middle-aged adults is a procedure done when the aortic valve becomes so incompetent, that replacement is the only viable option for the patient. A bioprosthetic or a mechanical valve is then chosen and replaces the patients’ native aortic valve. For these adults, this procedure is life-extending and the only option for prolonged survival. This paper will address whether a bioprosthetic or mechanical valve would be the better option for prolonging a middle-aged patients’ life. Methods: A literature search was completed in November of 2019 using PubMed and Google Scholar. Seven articles were chosen based on the overall relevance to the research question, study design, outcome, and results. Results: Based on the review, there is evidence of both mechanical and bioprosthetic valve types being a better option for different patient populations. One study found that patients with no pre-existing conditions, who were between the ages of 50 and 69 had similar outcomes with either valve type. Another study, however, found that middle-aged patients who were on dialysis fared better opting for a mechanical valve, but with higher incidences of bleeding. Overall, it seemed to be patient population dependent and hard to generalize to an entire population. Discussion: Most studies found that either a mechanical or bioprosthetic valve was a viable choice for middle-aged patients requiring aortic valve replacement. These studies included untoward events that may skew results, and they also included comprehensive statistical evaluation of their data. Conclusion: Selection of the type of valve for replacement should be left to the patient and their health care provider. Evidence from the literature analyzed suggests that for the best outcomes, replacement should consider multiple aspects of a patient’s medical history