Surgical therapy

Biological and Mechanical Valve Replacement

Depending on age, co-morbidity and individual characteristics, there are different options for surgical valve replacement.

Mechanical valve replacement: Today, almost all prostheses used are of the bileaflet type and made of pyrolytic carbon. The age-limit for mechanical valve replacement is 65 to 70 years. An advantage of mechanical prostheses is their durability. The risk of thrombo-embolism and the need for long-term anticoagulation are important disadvantages.

Mechanical bileaflet valve

Biological valve replacement: A comparatively large spectrum of biological valves is available. Generally, long-term anticoagulation is not required because biological valve prostheses are almost not thrombogenic. On the other hand, the incidence of valve re-replacement increases over time due to degeneration. Therefore, 65 to 70 years are accepted as the lower age-limit, although exceptions can be made depending on individual patient characteristics. The autograft used as part of the Ross procedure represents a special kind of biological valve replacement and has an upper age limit of 50 years. Various biological prostheses made of porcine heart valves are available: Stented porcine valves or valves constructed out of bovine or equine pericardium as well as stentless prostheses manufactured from porcine tissue or from bovine or equine pericardium.

Stent valve prostheses constructed from porcine aortic valve cusps	Stent valve prostheses of bovine pericardium