Recommendations | COR | LOE |
Choice of valve intervention and prosthetic valve type should be a shared decision process | I | C |
A bioprosthesis is recommended in patients of any age for whom anticoagulant therapy is contraindicated, cannot be managed appropriately, or is not desired | I | C |
A mechanical prosthesis is reasonable for AVR or MVR in patients <60 years of age who do not have a contraindication to anticoagulation | IIa | B |
A bioprosthesis is reasonable in patients >70 years of age | IIa | B |
Either a bioprosthetic or mechanical valve is reasonable in patients between 60 and 70 years of age | IIa | B |
Replacement of the aortic valve by a pulmonary autograft (the Ross procedure), when performed by an experienced surgeon, may be considered in young patients when VKA anticoagulation is contraindicated or undesirable | IIb | C |
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