Changing landscape of valve selection (and how it relates to age)

[pellicle]

If you're reading this and you're under 60 then you're a statistical outlier. If you're a male and aged 70 years then things are a changing in AVR.

When I was a kid and had my first OHS they just didn't do valve replacement on people in their 70's (surprisingly difficult to find median age for OHS for AVR or MVR per year since 1974). With this in mind I present this paper:

https://pubmed.ncbi.nlm.nih.gov/34780091/

Aortic valve replacement rates in Australia from 2004 to 2019​

which shows some interesting data points

• Absolute rates of AVR increased from 3631 to 7277 with a significant 22% age-adjusted rise seen
• This trend was more pronounced in men than women and in those aged >80 years
• [perhaps unsurprisingly] Proportion of mechanical AVR implanted fell from 38.4% to 8.6%
• A total of 2683 transcatheter aortic valve implantation (TAVI) procedures was performed in 2019, representing a 52% annual increase from 2014.
• [balloon aortic valvuloplasty] BAV increased from 66 procedures in 2004 to 862 in 2019.

Accordingly it seems that the "industry" has changed from what it was in 1974 to encompass areas which were previously non-existent and to focus more on geriatric treatment. I'm sure its a coincidence that these people are increasingly well funded (largely by dint of medical insurance).

So what I'm saying here is that you'll need to be even more cognizant of that when doing research on "whats what" with valve choice. Because now more than ever statistically its this:

Best Wishes