Early Mortality After Aortic Valve Replacement With Mechanical Prosthetic vs BioprostheticValves Among Medicare Beneficiaries: A Population-Based Cohort Study

In this manuscript, the authors describe their findings of a cohort analysis of 66 453 Medicare beneficiaries over the age of 65, who underwent aortic valve replacement (AVR) ± CABG and compare date of surgery, 30-day and one-year mortality between those receiving biological and mechanical prosthesis.

The mortality rate for the date of surgery and the first 30 days after the date of surgery was statistically higher among mechanical valve recipients than biological valve recipients. The unadjusted OR for death between recipients of mechanical and biological prosthesis was highest on the date of surgery. The difference in mortality rate between both groups was not statistically significant for the first 30 days after the date of hospital discharge and within 31 to 365 days after the date of surgery. Subgroup analyses suggest that the mortality difference between recipients of biological and mechanical valves in the overall population is primarily driven by high-risk patients who underwent concurrent CABG. Patients undergoing isolated AVR may have little or no increased risk for early death after mechanical AVR when

compared with bioprosthetic AVR.