European Journal of Molecular & Clinical Medicine

Abstract

Background: Heart valve replacements carry the pinnacle in surgical treatment for the patients with major cardiac illness though its ideas are not clear about their use due to many confounding factors like upsurge in incidences of stuck valve and anticoagulant related bleeding. The aim of our study was to compare outcomes after mitral, aortic or double valve replacements with mechanical versus bioprosthetic valves.
Methods: Data of 103 patients who underwent cardiac valve replacement [62 mitral, 25 aortic, and 16 double valve] with either mechanical [bileaflet valve, n=54] or biological [Hancock II, n=49] valve were retrospectively analyzed. Specific outcomes evaluatedwhich includefrequencies of valve thrombosis, systemic thromboembolism, anticoagulant related bleeding, structural valve dysfunction, prosthetic valve endocarditis, reoperation and death.
Results: Both the groups were comparable preoperatively except that patients receiving biological valve were more likely to be female and belonging to a rural setup. 30 day mortality was comparable in both groups. Incidences of valve related complications were significantly commoner in mechanical valve group. Two patients with mechanical valve required reoperation for stuck prosthetic valve at about 3 years after primary operation. Prosthetic valve endocarditis was not reported in either group. At 5 years there was no incidence of structural valve dysfunction was seen.
Conclusions: Mechanical valves are associated with a significantly higher complication rate compared with biological valves in Indian patients. Biological valves thus maybe specifically suited to the Indian scenario. However, in choosing a prosthetic valve, patients’ involvement and informed consent should take the utmost importance.