Selecting the best heart valve for your patient: mechanical or tissue.
This review provides general guidance for heart valve selection. Mechanical heart valves exhibit excellent durability and hemodynamic performance but require anticoagulation to reduce thromboembolism, and therefore risk of anticoagulation-related hemorrhage is increased. Tissue valves were introduced to avoid anticoagulation, but in fact often do not, and lack durability. A literature review was performed to compare the complications of thromboembolism, anticoagulation-related hemorrhage, reoperation structural valve deterioration, and reoperative mortality associated with mechanical and tissue valves. The thromboembolism rates for mechanical and tissue valves are equivalent. During their lives, many recipients of tissue valves receive anticoagulation therapy due to comorbid conditions. The anticoagulation-related blood loss rates associated with mitral mechanical valves and mitral tissue valves are equivalent, whereas the blood loss rates associated with aortic tissue valves are less than those associated with aortic mechanical valves.
Phillips
Steven J
SJ
National Library of Medicine, National Institutes of Health, Bethesda, MD, USA. sphillip@mail.nih.gov
D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D000075202:Contraindications; D003657:Decision Making; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data*; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D013923:Thromboembolism / Q000139:chemically induced / Q000517:prevention & control; D019737:Transplants / Q000706:statistics & numerical data*
D000925:Anticoagulants