Prosthetic heart valves: bioprosthetic versus mechanical

What it is

There are two kinds of prosthetic heart valve, and the choice between them is a single trade: anticoagulation against durability.

• Bioprosthetic valve: usually does not require anticoagulation. Durability is 10-15 years, and less in dialysis patients and in the young.
• Mechanical valve: requires anticoagulation. Durability is indefinite.

So the young person, in whom a bioprosthetic valve lasts least, is the one who most needs a mechanical valve, and with it anticoagulation.

How it is treated

A bioprosthetic valve is chosen for a chronic bleeding problem, a life expectancy under 5 to 10 years, pregnancy, or patient preference about anticoagulation. A mechanical valve is chosen for everything else.