1️⃣ Pls Read the entire thread (2 min) What's your valve choice in a healthy 56 yo with severe symp aortic stenosis? #cardiotwitter #MedTwitter #AHA @ACCinTouch @Heart_BMJ @TCTMD @SCAI @crfheart @crfshj @TAVRBot @Open_HeartBMJ @escardio @PCRonline @ESC_Journals @AHA_Research
2️⃣ If you chose BP valve, what's your one strong reason?
3️⃣ If you chose Mech valve, what's your one strong reason?
4️⃣ ESC and ACC/AHA guidelines differ in age cut offs for BP vs Mech valves. This leaves a big group of patients who need to choose a valve based on their preferences. But do we discuss all major risks/benefits properly as most patients depend on physicians for the right choice?
5️⃣ @NEJM study showed 35% increase in use on BP valves over the past 2 decades. Higher mortality and reop in younger age groups with BP valves. Published studies aren't powered for rarer but clinically important ends points as #endocarditis.
6️⃣ In clinical practice, do you discuss risk of endocarditis with patients?
7️⃣ Pls read the entire thread 1️⃣ to 7️⃣ ⬆️
Our study with Drs Rick Nishimura, Baddour, Schaff, Murad, @yreddyhf, @DrVarunSundaram-a Meta analysis of RCTs & prop matched 📚 comparing BP with Mech valves found ⬆️⬆️⬆️ incidence of endocarditis with BP valves https://heart.bmj.com/content/early/2020/05/29/heartjnl-2020-316718?rss=1
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