National Trends in Utilization and In-Hospital Outcomes of Mechanical vs. Bioprosthetic Aortic Valve Replacements

The authors analyzed all patients greater than age 18 in the National Inpatient Sample from 1998-2011 to evaluate trends and outcomes of tissue vs. mechanical aortic valve replacements. Implantation of tissue valves increased overall from 38% to 64% when comparing the earlier era to the later one.  The patients undergoing tissue AVR had a greater presence of comorbidites and concomitant operations.  Whereas the complication rate was higher in the tissue valve population, the mortality rate was lower.  Interestingly, lower volume facilities tended to favor mechanical AVR and higher volume facilities tended to favor tissue AVR.