Tissue heart valves may perform better

New research has suggested that some patients may react better to heart valves made from tissue, rather than those made from metal.
 
A review, published online by Annals of Thoracic Surgery, found that patients between the ages of 40 and 70 who need an aortic valve replacement (AVR) could benefit from having a tissue-based valve instead of a metal one.

These findings could help improve treatment of older patients, as well as boosting outcomes for heart valve replacements. 

Both mechanical metal valves and bioprosthetic tissue valves have pros and cons, which can sometimes make it a difficult choice for patients and their families. Metal-based valves can last longer, but they have a higher risk of developing blood clots, meaning patients have to take anticoagulants for the rest of their lives. 

While bioprosthetic valves are less likely to cause clotting, they don't last as long and people often have to undergo another procedure to have it replaced. 

Altogether the research team at the University of Australia reviewed 13 studies that looked at the outcome of mechanical and bioprosthetic valves in middle-age patients. 

"We combined the best available evidence comparing mechanical valves versus bioprosthetic valves to determine the risks and benefits to patients following surgery, depending on the type of valve they received," said Dr James J. Wu, from The University of Sydney in Australia. 

"We hope that our results can give future patients needing AVR more information to help them choose the appropriate replacement valve for their condition."

Along with Dr Paul G. Bannon, Dr Wu evaluated the studies and found there was no difference in a number of factors including survival, stroke rate, and infections for either valve.

However, patients who had bioprosthetic valves were twice as likely to need it replaced because the valve had become worn out. In contrast, those with mechanical valves were twice as likely to experience a major bleeding event or a blood clot.

As this is a potentially life-threatening event, the researchers said bioprosthetic valves should strongly be considered for patients in this age group, but also highlighted that each decision needs to be based around the individual.

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