{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:40:50Z","timestamp":1788183650594,"version":"build-2803163510"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Contemporary nationwide data on the use, predictors, and outcomes of mechanical valve replacement in patients less than 70\u00a0years of age are limited.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We identified hospitalizations for aortic valve replacement (AVR) or mitral valve replacement (MVR) in the Nationwide Inpatient Sample between January 1, 2008, and December 31, 2017. The study's end points included predictors of mechanical valve replacement and risk\u2010adjusted in\u2010hospital mortality. Among 253\u00a0100 hospitalizations for AVR, the use rate of mechanical prosthesis decreased from 45.3% in 2008 to 17.0% in 2017. Among 284\u00a0962 hospitalizations for MVR, mechanical prosthesis use decreased from 59.5% in 2008 to 29.2% in 2017 (\n              <jats:italic>P<\/jats:italic>\n              for trend&lt;0.001). In multilogistic regression analyses, female sex, prior sternotomy, prior defibrillator, and South\/West geographic location were predictive of mechanical valve use. The presence of bicuspid valve was a negative predictor of mechanical AVR (odds ratio [OR], 0.68; 95% CI, 0.66\u20130.69;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), whereas mitral stenosis was associated with higher mechanical MVR (OR, 1.28; 95% CI, 1.22\u20131.33;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Unadjusted in\u2010hospital mortality decreased over time with AVR but not with MVR, regardless of prosthesis choice. Using years 2008 and 2009 as a reference, risk\u2010adjusted mortality also decreased over time with AVR but did not decrease after MVR.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">There is a substantial decline in the use of mechanical valve replacement among patients aged \u226470\u00a0years in the United States. Long\u2010term durability data on bioprosthetic valve replacement are needed to better define the future role of mechanical valves in this age group.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019929","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T20:01:29Z","timestamp":1624305689000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Predictors of Use and Outcomes of Mechanical Valve Replacement in the United States (2008\u20132017)"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3847-0959","authenticated-orcid":false,"given":"Mohamad","family":"Alkhouli","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic School of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Division of Cardiology West Virginia University Morgantown WV"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Simard","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic School of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorin","family":"Pislaru","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic School of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartzell V.","family":"Schaff","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic School of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4651-9740","authenticated-orcid":false,"given":"Rich A.","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic School of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2010.202"},{"key":"e_1_3_1_3_2","first-page":"30182","article-title":"Trends in MitraClip, mitral valve repair, and mitral valve replacement from 2000 to 2016","volume":"0022","author":"Zhou S","year":"2020","unstructured":"Zhou S, Egorova N, Moskowitz G, Giustino G, Ailawadi G, Acker MA, Gillinov M, Moskowitz A, Gelijns A. 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