INTRODUCTION
Aortic valve replacement (AVR) continues to be the mainstay of therapy for severe valvular disease, and surgeons remain faced with a wide array of prosthetic valve options. Broadly, prosthetic valve types can be subdivided into mechanical or bioprosthetic, with bioprosthetic valves being further subdivided into stented and stentless valves. With the advantages of avoiding anticoagulation and the option of future valve-in-valve transcatheter aortic valve replacement (TAVR), bioprosthetic valve use has been increasingly favored over mechanical valve use in the elderly and middle-aged populations.1,2 While there are guidelines regarding the use of bioprosthetic versus mechanical aortic valves in certain patient populations, there is no consensus on the use of bovine pericardial versus porcine bioprosthetic valves.3 As such, the choice of bioprosthetic valve type continues to be left to surgeon preference. Recent studies suggest that bovine valves are used more commonly than porcine valves, comprising roughly two thirds of all bioprosthetic AVRs.4,5,6
Prior studies comparing bovine and porcine valves in the aortic position have had conflicting results, with some studies demonstrating differences in survival and reintervention rates, and other studies showing no differences between the two valve types. Due to the lack of consensus and inconsistent findings in the available literature, we performed a propensity-matched study of patients at our center who underwent isolated aortic valve replacement with either a bovine or a porcine valve. This study sought to evaluate the specific impact of valve type on both short-term and long-term outcomes.