Background This study evaluated outcomes in younger patients, specifically aged 50 years
and younger, after mechanical aortic valve replacement (mAVR) and bioprosthetic AVR
(bAVR). Methods From 1994 to 2016, 643 patients underwent AVR (411 mAVR and 232
bAVR) at age 50 or younger. Concomitant coronary artery bypass grafting and mitral valve
procedures were also included. Propensity score-matching methods resulted in 170 evenly
matched patient pairs. Primary end points were operative mortality and long-term survival …

Mechanical valves used for aortic valve replacement (AVR) continue to be associated with
bleeding risks because of anticoagulation therapy, while bioprosthetic valves are at risk of
structural valve deterioration requiring reoperation. This risk/benefit ratio of mechanical and
bioprosthetic valves has led American and European guidelines on valvular heart disease to
be consistent in recommending the use of mechanical prostheses in patients younger than
60 years of age. Despite these recommendations, the use of bioprosthetic valves has …