Heart valve replacement: which valve for which patient?
The ideal heart valve substitute would show no deterioration or thrombogenicity, offer no resistance to blood flow, and be easy to implant. However, such a valve does not exist and we must accept compromises in some of these qualities based on our patients' needs. In selection of cardiac valve prosthesis, valve-related factors such as durability, thrombogenicity, and fluid dynamics should be carefully matched to patient-related factors such as age, size, life expectancy, comorbidities, plans for pregnancy, and lifestyle. In addition, surgeon- or operation-related factors should be considered. Technical aspects of implantation, ease of reoperation, and operative mortalities may tip the risk and benefit balance in a particular direction. We review currently available heart valve prostheses and the clinical factors that are involved in selection of a heart valve substitute.
Huh
Joseph
J
Michael E. DeBakey Veterans Affairs Medical Center (112), 2002 Holcombe Boulevard, Houston, TX 77030, USA. jhuh@bcm.tmc.edu
Bakaeen
Faisal
F
D000367:Age Factors; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001021:Aortic Valve; D001705:Bioprosthesis; D003657:Decision Making; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000592:standards*; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D008943:Mitral Valve; D012086:Reoperation; D012307:Risk Factors
D000925:Anticoagulants