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.