Heart World Conference 2026

Abstract

Introduction

Heart valve surgery continues to be a serious health problem throughout the world, and valve repair is often not possible in many patients, especially in rheumatic cases, where valve replacement is often required. The best type of heart valve, mechanical vs. tissue, continues to be controversial and requires careful consideration by the heart team and patient. Recent advances in valve tissue technology may significantly impact this decision.

Material & Methods

From Jan. 2003 to Jan. 2025, 1775 patients underwent heart valve replacement by a single team. 853 patients were male and 922 were female, with age ranging from 8 to 95 years. Patients were divided into two groups, A) 1017 with mechanical and B) 758 with bioprosthetic valves. 295 cases were redo surgery and 648 cases were multiple valve surgery procedures. Long-term outcomes, major adverse events and quality of life indices were studied in the two groups.

Results

Hospital mortality was similar in both groups. However major adverse events were more frequent in the mechanical valve group, despite their younger mean age (26.9% vs 12.0%, p<0.01). Major bleeding and stroke were significantly higher in the mechanical valve group as well (12.7% and 3.0% vs 4.7 and 1.7%, respectively, p<0.01). Rate of need for redo surgery was higher in the tissue valve group. Long-term survival did not significantly differ in the two groups, but quality of life indices were significantly higher in the tissue valve group.

Conclusion

We conclude that mid and long-term morbidity are worse, and major adverse events and complications are more devastating in patients with mechanical heart valves. More redo surgery did not negatively impact survival in the tissue valve group, and mechanical heart valves associated with life-long warfarin use can have a substantial negative impact on quality of life of patients. These factors must be kept in mind with regard to life-long management of heart valve replacement patients.

Keywords
prosthetic heart valve - mechanical heart valve - tissue heart valve – complications – quality of life