Biological Valve Prosthetics: what they are
Table of Contents
The biological valve prostheses I am artificial heart valves made with fabrics of animal originUsually pericardio bovino o porcine valve.
They represent aalternative to mechanical prosthesesoffering good functionality and the important advantage of not requiring lifelong anticoagulants.
They are particularly suitable for patients who cannot, or do not want, take it anticoagulant therapy long term.
They offer one simpler life e lower risk of bleedingcompared to a limited duration compared to mechanical prostheses.
The choice must be personalized, carefully evaluating:
- age;
- clinical conditions;
- lifestyle.
What are heart valves?
Types of biological prostheses
Based on the material and structure, the main types are:
- Porcine prostheses: they use the entire aortic valve of the pig, treated and mounted on a support (stented) or, more rarely, without support (stentless).
- Bovine pericardial prosthesis: the cusps are obtained from the bovine pericardium, modeled and fixed on a support.
Advantages
- Absence of long-term anticoagulant therapy: It is not necessary to take chronic oral anticoagulants (such as warfarin), reducing the risk of bleeding and simplifying daily management.
- Better quality of life: does not require frequent blood checks or food restrictions related to anticoagulant therapy.
- Ideal choice for those who cannot use anticoagulants: for example, patients with high risk of bleeding or women wanting to become pregnant.
- Lower risk of valve thrombosis: the biological material has a low thrombogenic potential.
Disadvantages
- Limited duration: the biological valve tends to degenerate over time (on average after 10–15 years), sometimes making a new operation necessary.
- Structural degeneration: the tissue may calcify or lose elasticity, compromising correct functioning.
- Possible need for reoperation: the replacement can take place with traditional surgery or with a percutaneous procedure (valve-in-valve).
- Variable duration in recent percutaneous valves (TAVI): Long-term results are still being studied.
The Valvular Disease Center of Auxologico
Biological or mechanical prosthesis?
The choice between biological prosthesis e mechanics depends on several factors:
- Age: preferred in patients over 60–65 years of age, whose life expectancy is similar to the lifespan of the valve;
- Management of anticoagulation: indicated in those who have difficulty controlling o tolerate anticoagulant therapy;
- Pregnancy: recommended for women of childbearing age, to avoid the risks of anticoagulation during gestation;
- Percutaneous procedures (TAVI): Only biological valves can be implanted with minimally invasive techniques without open heart surgery.
Clinical management and follow-up
- After the surgery a short anticoagulant or antiplatelet therapy (generally for a few weeks or months);
- Il type and duration of treatment depend on location of the prosthesis (aortic or mitral) and any others heart conditionslike the atrial fibrillation;
- It is important to carry out periodic cardiological checks and regular echocardiograms to evaluate the state of the prosthesis over time.
Mechanical Prostheses
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