Introduction
The ultimate goal of mitral valve surgery in young women is to extend
life expectancy and improve and improve quality of life. Mitral valve
replacement (MVR) prosthesis in middle-aged women is a difficult choice
between the lifelong anticoagulation of mitral mechanical prosthesis
(MMP) versus the limited long-term durability of
mitral bioprosthesis (MBP). The current trend towards
reducing women’s age for selecting MBP over MMP leads to a dilemma for
younger women decision making.[1,2] However, limited literature
supports the use of MBP over MMP, and many surgeons and
cardiologists recommend reducing women’s age for MBP.[3 ]
The guidelines of the American College of Cardiology/American Heart
Association advise using BMP for sinus rhythm in young women who choose
this valve according to their lifestyle considerations, after having
been comprehensively informed on the anticoagulation risk of MMP versus
the necessity of future reoperation after MBP.[4]
Several studies have reported that both MBP and MMP
have equivalent effects on postoperative survival and quality of life
in the middle-aged population.[5,6]
Young women, particularly those in child-bearing period, are concerned
about MMP due to its bothering valve sounds, the need of repeated
medical visits and blood tests, as well as the probability of
anticoagulant-related teratogenicity, thrombosis, and bleeding
complications. [7]
The aim of this study was to compare the safety, freedom from
complications during pregnancy, and the survival rate after MBP versus
MMP in young women for whom mitral valve repair is not feasible or
unsuitable.