Application of Biological Heart Valves (BHV) and Mechanical Heart Valves (MHV) in the Female Patients of Childbearing Age: a Matched Paired Study

Objective To observe the efficacy and safety of biological heart valves (BHV) and mechanical heart valves (MHV) in childbearing age women (CAW) during the perinatal and short-moderate term postoperative (SMTP) periods. MethodsThere were 33 patients 〔(25.2±7.1） yr.〕 undergoing BHV replacement from September 2009 to December 2014 had completely followed-up, whose data were retrospectively collected. A 1∶4 matching study was conducted, therefore there were 132 patients undergoing MHV were included. The collected date included the clinical outcomes in the perioperative, perinatal, and SMTP period event-free survival (EFS) was determined using the Kaplan-Meier method and compared using the log-rank test. Results The average follow-up time was （5.8±3.6） years, and the two groups had similar baseline . The clinical outcomes difference of perinatal and SMTP between the two groups were not significant. There were 17 patients in BHV group and 60 in MHV group with pregnancy and birth experiences (PBE), which also showed no significant difference for adverse events both in the maternity and in the fetus. The rates of valve-related adverse events of BHV replacement patients with and without PBE were 5.9% and 0% at 3 years after the operation，and 11.8% and 5.9% after 5 years. PBE was not identified as an adverse prognostic factor for EFS (P=0.43). ConclusionsEither artificial BHV or MHV replacement can achieve ideal SMTP effect in CAW. BHV seems not superior to MHV. Pregnancy and birth experience will not increase the risk of BHV relevant adverse events.