Selection of a prosthesis for aortic valve replacement

The results following aortic valve replacement with mechanical valves such as the Silastic ball valve demonstrate a low incidence of valve-related mortality and morbidity over a long period of follow-up, up to 20 years. The more recently devised mechanical valves offer some advantage with regard to haemodynamics but, on balance, introduce the potential of other risks involving structural durability over the long term. Glutaraldehyde preserved tissue valves have their primary indication in patients for whom anticoagulation poses an excessive risk or who have a life expectancy of 10 years or less. Recent reports suggest that cryopreserved free aortic homograft offers some advantage, especially for younger patients, beyond that achieved by glutaraldehyde preserved tissue.