Mechanical heart valves may be safer in certain cases than valves made of animal tissue and should be used more in heart-valve replacements, especially in younger patients, according to a study by researchers at the Stanford University School of Medicine.
The study also found that unlike what’s recommended in the national guidelines, which say patients ages 50 to 70 undergoing aortic or mitral valve replacement should be given a choice of either a mechanical or biological valve, the best choice in fact can hinge on whether the aortic or mitral valve is being replaced.
The study shows that for patients undergoing mitral valve replacement, a mechanical valve is actually beneficial until the age of 70. On the other hand, for patients undergoing aortic valve replacement, the benefit of implanting mechanical valves ceased after the age of 55.
“This has potential to significantly impact the current national practice guidelines,” said Joseph Woo, MD, professor and chair of cardiothoracic surgery at Stanford, who routinely performs these surgeries. “While our preference is always to repair heart valves whenever possible, there are certain disease processes which necessitate valve replacement. For these patients, given the study’s new and unexpected findings, I am already pondering, ‘How am I going to counsel my patients today?’ The advice may not be the same as the current national guideline recommendations.”
The study will be published Nov. 8 in The New England Journal of Medicine. Woo is the senior author. Postdoctoral scholar Andrew Goldstone, MD, PhD, is the lead author.
Most patients who need open-heart surgery to remove a diseased heart valve face complicated conversations with their heart surgeons about whether to…