Are Mechanical Heart Valve Replacements Better for Long-Term Survival?

Patients between the ages of 50 and 70 years with a mechanical heart valve have better long-term survival than those who have a biological valve, according to research published in the European Journal of Cardio-Thoracic Surgery.

According to current guidelines, the use of mechanical valves made with synthetic materials is favored for patients younger than 50, whereas biological valves made of animal tissue are recommended for those older than 65. The existing guidelines leave the  decision to surgeons and patients aged 50 to 70 years.

To determine the clinical outcomes for patients aged 50 to 70 years undergoing elective and urgent heart valve replacement, researchers analyzed a total of 1,708 patients (61% male) with an average age of 63 years. In the population of interest, nearly 70% received a biological valve replacement.

The results showed that there were no short-term differences observed when  patients who received biological valves were compared with those who received mechanical valves. However, the investigators noted that patients with mechanical valves had better long-term survival up to 13 years after valve replacement.

“Our study has implications for decision-making in surgical heart valve replacements for patients aged between 50 and 70 years old,” said Gianni Angelini, the British Heart Foundation Professor of Cardiac Surgery at the Bristol Medical School: Translational Health Sciences, director of the Bristol Heart Institute, and corresponding author in a press release. “The evidence supporting better long-term survival in patients receiving a mechanical heart valve suggests the current trend favouring biological valves in this age bracket should be urgently reconsidered. The survival benefit is especially clear in smaller sized valves.”

Source

Mechanical heart valve replacements have better long-term survival, study finds. News release. University of Bristol. February 11, 2025. Accessed March 11, 2025. https://www.eurekalert.org/news-releases/1073290