The choice between bioprosthetic or mechanical prosthetic valve replacement for active @entity340 has been controversial. To establish the role of each, we reviewed the case histories of 185 @entity1 who underwent valve replacement for active @entity340 during the past 5 years. All @entity1 had life-threatening, active @entity3555 of a native or prosthetic valve. Group I (88 @entity1 ) had replacement with the Ionescu-Shiley pericardial valve and Group II (97 @entity1 ) with the St. Jude Medical valve. The male/female distribution, age range, and functional classification were the same in the two groups. Mean follow-up was approximately 20 months for both groups. Valve replacement was done because of @entity340 in 76 @entity1 in Group I and 49 @entity1 in Group II. Of the remainder of the Group I @entity1 , six had @entity884 of a bioprosthesis and six of a mechanical valve; of the remainder of Group II @entity1 , 30 had @entity884 of a bioprosthesis and 18 of a mechanical valve. Early mortality was not significantly different between the two groups (14 @entity204 in each group). Of the 74 survivors in Group I, 15 underwent valve reoperation, 10 because of recurrent @entity884 and five because of sterile perivalvular leakage. The frequency of reoperation was significantly different (p less than 0.01) from that in Group II, in which only five @entity1 underwent valve reoperation, four for recurrent @entity884 and one for sterile perivalvular leakage. The actuarial rate for freedom from reoperation was also significantly higher in Group II @entity1 ; 94.6% were free from reoperation at 4 years compared to 75% at 4 years in Group I @entity1 (p less than 0.01). The actuarial survival rate, which also differed significantly between groups, was 78.7% at 4 years in Group I and 87.4% at 4 years in Group II (p less than 0.05). @entity1 receiving a bioprosthesis for @entity3457 had a significantly higher reoperation rate and a significantly greater incidence of recurrent @entity884 (p less than 0.01). Therefore, we prefer to use a mechanical valve for valve replacement in most @entity1 who have @entity3457 .

Comparison of bioprosthetic and mechanical valve replacement for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity3457 :: ('OMIM:612348', 'Disease') :: ['active endocarditis'] @entity340 :: ('MESH:D006349', 'Disease') :: ['valvular endocarditis', 'native valve endocarditis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths'] @entity3555 :: ('MESH:D004697', 'Disease') :: ['bacterial endocarditis'] @entity884 :: ('MESH:D004696', 'Disease') :: ['endocarditis']
@entity3457 :: (OMIM:612348,Disease) :: ['active endocarditis']
