There are also differences in statistical survival depending on your age.
The article below is a synthesis (I.e. summary) of studies that compared the survival consequences of a mechanical vs a tissue valve.
It basically says that if you look across the literature, if you are less than 50, there is no survival advantage. In the 50-70 group, mechanical valves offer a survival benefit over tissue valves, and the in the 70 plus group, tissue valves offer a survival benefit over mechanical ones.
Mechanical valves or bioprosthetic valves may be employed to substitute the native aortic valve in aortic valve replacement (AVR) procedures [1].
academic.oup.com
There are a few things to keep in mind when looking at these statistical studies, which refer to populations. Younger people tend to be have less concurrent disease on average than an older people. So perhaps the less than 50 years result is just reflective of underlying baseline health. in other words,
survival after surgery really depends on your individual circumstances.
Finally, I would say that
many of these statistical results are likely not as applicable today. To get 20 years results in Humans, you need to rely on technology from 20 years ago. But the
underlying technology changes over time, including for mechanical valves. I.e. For mechanical valves, sef-testing and self-management are now much more common in many countries and across age groups (20 years ago it was just Germany that was really using this technology on a large scale). This apparently reduces anti-coagulant related side effects by 40% or even more.
For tissue valves, the inspiris resilia and foldax valves could turn out to be much more long-lasting than the tissue valves we have today, but there is no way of knowing.
The only thing that is still certain is that you will likely not need a re-op with a mechanical valve. With a tissue valve its not so clear anymore (I.e. if you are 60 and get 10-15 out of a tissue valve, then you are probably TAVI candidate, so no more OHS required. However TAVI is not a risk-free option/procedure. The data show a higher pacemaker rate with TAVI.
Good luck with your decision.
