The choice between bioprosthetic and mechanical aortic valve replacement in younger patients is controversial because long-term survival and major morbidity are poorly characterized.
Results No differences in survival or stroke rates were observed in patients with bioprosthetic compared with mechanical valves.
Actuarial 15-year survival was 60.6% in bioprosthesis vs 62.1% in the mechanical prosthesis group
The 15-year cumulative incidence of stroke was 7.7% vs. 8.6%.
The 15-year cumulative incidence of reoperation was higher in the bioprosthesis group 12.1% vs. 6.9%
The 15-year cumulative incidence of major bleeding was higher in the mechanical prosthesis group 13.0% vs 6.6%
The 30-day mortality rate was 18.7% after stroke, 9.0% after reoperation, and 13.2% after major bleeding.
Conclusions and Relevance Among propensity-matched patients aged 50 to 69 years who underwent aortic valve replacement with bioprosthetic compared with mechanical valves, there was no significant difference in 15-year survival or stroke.