A valve is a mobile, thin sheet of tissue present in a pathway, and maintains a unidirectional flow through the passage. The heart valves become insufficient, or they get stenosed. Patients with damaged aortic valves are managed with medicines, aortic valve repair, surgical or transcatheter aortic valve replacement. Prosthetic heart valves used for replacement of damaged aortic valves are of two types, mechanical and bioprosthetic. Three common types of mechanical heart valves are disc valves, bi-leaflet valves, and ball and cage valves. Bioprosthetic valves are further divided into xenografts (from animals), homografts (from the same species), and autografts (from the same individual). Bioprosthetic valves can be stented on metallic support or can be attached directly to the aorta.
Stent placement reduces the lumen of the aortic valve and is not favorable hemodynamically, but there is no difference in the clinical outcomes of two types of valves. The selection of prosthetic valves depends upon the patient's choice, age, anticoagulation tolerance, risk of valve deterioration, anticoagulation status, future pregnancy plans, etc. Different types of bioprosthetic valves have similar mortality and reoperation outcomes. Transcatheter aortic valve replacement is a comparatively safer option for patients who cannot undergo an open-heart valve replacement procedure.
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