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To the Editor Mr Chiang and colleagues1 reported that patients aged 50 to 69 years who underwent aortic valve replacement had comparable 15-year survival with implantation of a bioprosthesis or a mechanical prosthesis, suggesting that bioprosthetic valves “may be a reasonable choice” in patients aged 50 years or older. We recognize that, in part because of the advent of transcatheter aortic valve implantation and the possibility of placing a transcatheter heart valve in bioprosthetic valves with structural valve deterioration,2 bioprostheses are becoming a more attractive alternative to mechanical prostheses.3 However, additional data are required before lowering the age cutoff for implanting bioprostheses can be justified.
Head SJ, Osnabrugge RL, Kappetein AP. Age Cutoffs for Bioprosthetic vs Mechanical Aortic Valve Replacement. JAMA. 2015;313(5):522-523. doi:10.1001/jama.2014.17228