What is the average age for heart valve replacement?

The average age for heart valve replacement varies depending on the type of valve being replaced and the specific condition of the patient. Studies have shown that for aortic valve replacement, the mortality rate for octogenarians was around 6.6% at 1 month and 11% at 1 year (Fish, 2004). In the case of pulmonary valve replacement in patients with Tetralogy of Fallot, the mean age for the first replacement is typically between 16 to 20 years, with many patients requiring a second replacement by age 30 to 35 years (Holmes, 2012).

For mitral valve surgery, there are important health and economic implications, especially for patients over 75 years of age, where mortality rates have been reported to be high, exceeding 14% in some cases (Rao & Foster, 2013). The choice between a bioprosthesis and a mechanical valve prosthesis also depends on age, with guidelines recommending bioprostheses for patients above 70 years and mechanical valves for those below 60 years (Glaser & Sartipy, 2016).

In the context of aortic valve replacement in younger patients, there is a trend towards using bioprostheses over mechanical valves due to patient preferences and concerns about long-term anticoagulant therapy (Mancini et al., 2021). Transcatheter aortic valve replacement (TAVR) has emerged as a transformative treatment for aortic stenosis in high-risk older adults, with promising outcomes (Rosner et al., 2013).

Overall, the decision for heart valve replacement is multifaceted, considering factors such as age, type of valve, patient preferences, and associated risks. The average age for heart valve replacement can vary widely based on these factors and should be determined on a case-by-case basis.

References #

1. Fish, R. (2004). Percutaneous heart valve replacement. Circulation, 110(14), 1876-1878. https://doi.org/10.1161/01.cir.0000144395.60800.96
2. Glaser, N. and Sartipy, U. (2016). Aortic valve replacement in middle-aged patients: is the increased use of bioprostheses justified?. Expert Review of Cardiovascular Therapy, 14(4), 405-406. https://doi.org/10.1586/14779072.2016.1143361
3. Holmes, K. (2012). Timing of pulmonary valve replacement in tetralogy of fallot using cardiac magnetic resonance imaging. Journal of the American College of Cardiology, 60(11), 1015-1017. https://doi.org/10.1016/j.jacc.2012.05.026
4. Mancini, V., Aziz, O., & Mauro, M. (2021). Commentary: a new little piece for a great puzzle. JTCVS Techniques, 5, 20. https://doi.org/10.1016/j.xjtc.2020.10.045
5. Rao, R. and Foster, E. (2013). Rethinking mitral valve surgery during the golden years. Circulation, 127(18), 1843-1846. https://doi.org/10.1161/circulationaha.113.002574
6. Rosner, G., Leon, M., & Schwartz, A. (2013). Counterpoint: access to transcatheter aortic valve replacement should not be limited to high-volume surgical centers.