Selection of Prosthetic Heart Valves

  There are two major categories of prosthetic valves: biologic valves and mechanical valves.  I. Biologic valves have good hemodynamics, low thromboembolic rates, and do not require long-term anticoagulation therapy, but the greatest disadvantage of biologic valves is their poor durability. Therefore, biologic valves are mainly used for the following patients: 1) women of childbearing age who wish to become pregnant; 2) in terms of age, biologic valves should be preferred for patients over 60 years of age and mechanical valves should be selected for patients under 50 years of age to ensure their durability and to avoid calcification of biologic valves in adolescents and the need for secondary valve replacement; 3) patients with bleeding qualities and bleeding disorders and other reasons who cannot receive long-term anticoagulation therapy 4, according to the patient’s economic and health care conditions, it is appropriate to use biological valves in rural areas where anticoagulation is not available; 5, the tricuspid valve is the site with the highest rate of thromboembolism among all valve replacement emboli, which may be related to the low pressure and slow blood flow at this site. Clinical observations in the tricuspid valve site thromboembolism rate is highest in the disc valve, followed by the ball valve, the lowest biological valve, so the tricuspid valve site valve replacement using biological valve is more ideal.  Second, mechanical valves have good durability, can be used for life, and are widely applicable to the population, with the disadvantage that they require lifelong anticoagulant medication.