Optimal Artificial Valve Selection for Koreans: 'Age Guideline' Released

Seoul Asan Hospital Professors Kim Junbeom and Kim Daehee Team

Domestic medical professionals have presented age-specific guidelines necessary for selecting artificial valves used in heart valve replacement surgery.

Professor Junbeom Kim from the Department of Cardiovascular and Thoracic Surgery and Professor Daehee Kim from the Department of Cardiology at Seoul Asan Medical Center recently announced on the 8th that their research results indicate it is safer to use mechanical valves rather than tissue valves for aortic valve replacement surgery in patients under 65 years old and mitral valve replacement surgery in patients under 70 years old.

Professor Junbeom Kim (left), Department of Cardiovascular and Thoracic Surgery, Asan Medical Center, Seoul, and Professor Dahee Kim, Department of Cardiology.

Heart valves function to ensure blood flows in one direction within the heart without backflow. If the valves do not function properly, severe cases may lead to pulmonary edema or cardiac arrest, necessitating valve replacement surgery to substitute the damaged valve with an artificial one. Artificial valves are chosen between mechanical and tissue valves based on the patient's age, gender, and condition.

Mechanical valves are semi-permanent once implanted but require anticoagulant medication due to the risk of thrombosis. Tissue valves do not require anticoagulants but have a lifespan of about 15 to 20 years, which may necessitate reoperation. Generally, younger patients receive mechanical valves, while older patients receive tissue valves; however, most studies defining the age criteria for this distinction are based on overseas data, highlighting the need for research on domestic patients.

The research team analyzed the mortality risk according to age and type of artificial valve in 24,375 patients who underwent heart valve replacement surgery from 2003 to 2018 using National Health Insurance data. First, analyzing the mortality risk by valve type in patients who underwent aortic valve replacement surgery showed that tissue valve patients had a 2.18 times higher mortality risk than mechanical valve patients in the 40?54 age group and 1.29 times higher in the 55?64 age group. Conversely, from age 65 onwards, tissue valve patients had about a 1.23 times lower mortality risk compared to mechanical valve patients.

Professor Kim Junbeom of the Department of Cardiovascular and Thoracic Surgery at Asan Medical Center in Seoul is performing an aortic valve replacement surgery.
[Photo by Asan Medical Center]

In the case of mitral valve replacement surgery, tissue valve patients had a 1.22 times higher mortality risk than mechanical valve patients in the 55?69 age group. For patients who underwent replacement of both the aortic and mitral valves, tissue valve patients had a 2.02 times higher mortality risk than mechanical valve patients in the 55?64 age group.

Professor Junbeom Kim stated, "Deciding which artificial valve to use in heart valve replacement surgery has been very important yet challenging, but there has been no research conducted on Asian patients, including those in Korea." He added, "Since the domestic age criteria for selecting artificial valves are about 5 to 10 years higher than Western standards, applying domestic criteria is expected to enable safer treatment for patients with heart valve disease."

Professor Daehee Kim added, "This study is the first heart valve-related research published using National Health Insurance big data," and said, "Through several ongoing studies, we expect to provide more precise evidence for the criteria of artificial valve selection for patients in Korea in the future."

The results of this study were recently published in the American Medical Association journal, JAMA Network Open (IF 13.360).

This content was produced with the assistance of AI translation services.