39  Mechanical/Bioprosthetic Heart Valves

	Mechanical Valve	Bioprosthetic Valve	Transcatheter Aortic Valve (TAVR)
Material	Plastic	Bovine, Equine, or Porcine pericardium or aortic valves	Porcine or Bovine pericardium
Lifespan	25-30 years	10-15 years	91% of pts at 5-10 yrs have functioning valves
Results	Durability ↓ incidence of ppm ↓ risk paravalvular leak	No AC ↓ incidence of ppm ↓ risk paravalvular leak	No AC Less invasive procedure ↓ mortality ↓ AKI ↓ bleeding ↓ stroke
Drawbacks	AC needed hemolytic anemia invasive procedure	Shorter lifespan Invasive procedure	Shorter lifespan

39.1 Anticoagulation

• Mechanical heart valves that should be on warfarin with an INR goal 2.5-3.5
  • mitral valve replacement
  • aortic valve replacement w/ risk factors
  • 1st 3 months after aortic valve replacement (weak rec)