Aortic valve replacement is the second most common cause of cardiac surgery. Over the last four decades, bioprosthesis has been widely used in aortic valve replacement. Though bioprosthetic valves are used to avoid long term anticoagulant therapy in patients post-surgery, the valves are at risk of structural deterioration, requiring redo surgery. Various studies have reported both mortality and durability only for a single decade of follow-up of aortic valve replacement. Additional long term follow-up results are required especially in patients who had aortic valve replacement at a younger age. Recent advancements in aortic valve replacement surgery are sutureless aortic valve replacement through percutaneous transcatheter heart valve technology. Since this technique also uses bioprosthesis, population demographic that can benefit from sutureless aortic valve replacement is unclear. Here, we report a patient who has been consistently documented follow-up for thirty-eight years after a successful aortic valve replacement with a bioprosthesis
The main query for the patients requiring aortic valve replacement (AVR) is to select between the kind of valve being either mechanical or bioprosthetic valve. The choice of valve the prosthesis is based on considering several factors including valve durability, expected hemodynamics for a specific valve size, the potential need for longterm anticoagulation, and patient values and preferences [1,2]. Sixty percent of the patients undergoing AVR choose mechanical valve and the remaining forty percent choose bioprosthesis . Follow-up of patients with bioprosthesis demonstrated structural valve deterioration (SVD) in implanted valves after six to eight years. According to various studies regarding the follow-up of patients with AVR, very few patients with original valve in place remain alive beyond fifteen years post AVR [3,4]. Nonetheless, durability of the bioprosthetic valves remains consistent during the first decade; additional long term followup studies are required to make them suitable for use in the younger patients.