{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:50:20Z","timestamp":1791237020005,"version":"4.1.0"},"reference-count":21,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,26]],"date-time":"2025-01-26T00:00:00Z","timestamp":1737849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"East Slovak Institute for Cardiovascular Diseases"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Aortic valve replacement (AVR) is the definitive therapy for patients with severe aortic valve stenosis (AoS). The aim of this work is to compare the effect of a mechanical prosthesis (MP) and a bioprosthesis (BP) on the survival of patients aged 50\u201365 years after AVR. Methods: The retrospective analysis included 276 patients aged 50 to 65 years who had undergone isolated AVR for AoS; 161 patients were implanted with an MP and 115 with a BP. Patient survival, adjusted for age, gender and risk parameters affecting survival, was assessed. A subgroup analysis was performed on the 208 patients with a modern valve (prosthesis models that are no longer used in clinical practice were removed from the sample). Results: After adjusting for risk factors for overall survival as well as for age and sex, the implantation of an MP did not have a significant effect on overall survival in comparison to a BP, at a median follow-up of 10.3 years (p = 0.477). The size of the MP had no significant effect on overall survival either (HR: 1.29; 95%CI: 0.16\u201310.21; p = 0.812). However, the indexed effective orifice area of the BP had a positive effect on overall survival (HR: 0.09; 95%CI: 0.01\u20130.78; p = 0.029). Conclusions: The estimated survival of patients aged between 50 and 65 years after implantation of a BP with a sufficiently large indexed effective orifice area may exceed that of patients with an MP.<\/jats:p>","DOI":"10.3390\/jcdd12020044","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T09:42:23Z","timestamp":1737970943000},"page":"44","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4195-5180","authenticated-orcid":false,"given":"Tom\u00e1\u0161","family":"Toporcer","sequence":"first","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef \u0160af\u00e1rik University, 04001 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5922-5958","authenticated-orcid":false,"given":"\u0160tefan","family":"Luka\u010d\u00edn","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef \u0160af\u00e1rik University, 04001 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Kraus","sequence":"additional","affiliation":[{"name":"Institute of Mathematics and Statistics, Faculty of Science, Masaryk University, 602 00 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8021-5453","authenticated-orcid":false,"given":"Mari\u00e1n","family":"Homola","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef \u0160af\u00e1rik University, 04001 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Bere\u0161","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef \u0160af\u00e1rik University, 04001 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9607-5949","authenticated-orcid":false,"given":"Michal","family":"Trebi\u0161ovsk\u00fd","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef \u0160af\u00e1rik University, 04001 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Rad\u00f3tzy","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef \u0160af\u00e1rik University, 04001 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vil\u00e9m","family":"Rohn","sequence":"additional","affiliation":[{"name":"II. Surgery Department\u2013Cardiovascular Surgery, General University Hospital and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9390-7191","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Koles\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef \u0160af\u00e1rik University, 04001 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"ezae177","DOI":"10.1093\/ejcts\/ezae177","article-title":"First-time surgical aortic valve replacement: Nationwide trends and outcomes from The Netherlands Heart Registration","volume":"65","author":"Daeter","year":"2024","journal-title":"Eur. J. 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