Right-sided mechanical valve prostheses in adults with congenital heart disease

Congenital heart disease (CHD) commonly includes right-sided valvular heart disease. Patients with CHD may require multiple sternotomies and interventions in their lifetime. The longevity of their replaced valve will be one of the most important factors determining freedom from re-intervention and overall prognosis. The European Society of Cardiology Guidelines for the management of adults with CHD have recommendations as to the indications and timing of pulmonary and tricuspid valve intervention1; however, whether to use a bioprosthetic or mechanical valve is not specifically outlined. The guidelines acknowledge that there is little experience with mechanical valves in this setting, raising concerns about adequate anticoagulation. The use of bioprosthetic valves as the primary choice for right-sided valve replacement is widespread and the inclination for bioprosthetic valves over mechanical valves stems from several practical considerations. This primarily includes avoidance of life-long commitment to vitamin K antagonist and its implications on patients...
Source: Heart - Category: Cardiology Authors: Tags: Editorials Source Type: research