There is no perfect prosthetic valve substitute for young and middle-aged patients requiring aortic valve replacement (AVR). The long-term risks of anticoagulation with a mechanical prosthesis must be weighed against the risks of structural valve deterioration of a bioprosthetic valve. In patients aged 20 to 40 years, the decision almost always leads to the selection of a mechanical valve and lifelong anticoagulation. Unfortunately, aortic valve repair is an option for only a small number of patients who are highly selected.
Bonow RO, O’Gara PT. Reconsidering the Ross Procedure. JAMA Cardiol. 2021;6(5):548. doi:10.1001/jamacardio.2021.0087
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