Date of Graduation

Winter 2-1-2011

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

Background: Treatment options for valvular heart disease include valve replacement with a mechanical or bioprosthetic valve. Mechanical valves are made from carbon, Teflon, Dacron, titanium and polyester and are intended to last a lifetime.

Bioprosthetic valves are made from valves of a pig or pericardium of a cow. Bioprosthetic valves are not as durable and have a shorter lifespan.

The main purpose of this systematic review is to compare the long-term outcome in mechanical and bioprosthetic valve replacement. The Grading of Recommendation Assessment Development and Evaluation (GRADE) tool will be used to evaluate the quality of evidence.

Methods: An extensive literature search was performed using PubMed, Medline, Cochrane Systematic Reviews, and CINHAL. Two randomized control trials and one observational study met the inclusion and exclusion criteria.

Results: Better survival with a mechanical valve implantation in AVR and similar survival with bioprosthetic and mechanical valve replacement in MVR was reported in two studies, while the third study reported similar survival in both valve groups. The two randomized control trials reported higher occurrence of bleeding in mechanical valve recipients. The observational study reported higher occurrence in bleeding in mechanical valve recipient for AVR. There were no differences in the number of embolism or endocarditis cases between the two valve groups.

Conclusion: Survival was reported to be similar in both valve type and position except in one study where there was better survival with a mechanical valve implantation in AVR.

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