Abstract:
PURPOSE OF REVIEW:There is controversy regarding the optimal choice of prosthetic valves in patients less than 65 years of age requiring mitral valve replacement (MVR). Recently, trends for valve replacement are moving towards biological prosthesis also in younger patients, which is justified by the fact that a later valve-in-valve procedure is feasible in the case of degeneration of the tissue valve. This strategy is increasingly recommended in aortic valve surgery but is questionable for MVR. The purpose of this review is to evaluate current guidelines and analyse evidence for biological MVR in patients under 65 years. RECENT FINDINGS:There are differences between guidelines of the American Heart Association and those of the European Society of Cardiology concerning the choice of prostheses in patients undergoing MVR. Although the European Society of Cardiology recommends a mechanical mitral valve in patients under 65 years of age, the American Heart Association does not provide detailed advice for these patients. Mitral valve replacement with biological valves in patients under 65 years is associated with higher rates of reoperation due to structural valve deterioration. In addition, several studies showed a decreased survival after biological MVR. SUMMARY:Evidence for biological MVR in patients less than 65 years without comorbidities or contraindication for oral anticoagulation does not exist. Recommendations for patients less than 65 years of age should not be blurred by current 'en-vogue' methods for promising but not yet proven valve-in-valve strategies.
journal_name
Curr Opin Cardioljournal_title
Current opinion in cardiologyauthors
Reineke DC,Heinisch PP,Winkler B,Englberger L,Carrel TPdoi
10.1097/HCO.0000000000000151subject
Has Abstractpub_date
2015-03-01 00:00:00pages
146-150issue
2eissn
0268-4705issn
1531-7080journal_volume
30pub_type
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
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journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
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journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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