ABC | Volume 112, Nº3, March 2019

Original Article Kiyose et al A systematic review for valvular prostheses Arq Bras Cardiol. 2019; 112(3):292-301 1. Pibarot P, Dumesnil JG. Prosthetic heart valves: selection of the optimal prosthesis and long-termmanagement. Circulation. 2009;19(7):1034-48. 2. Bonow RO, Carabello B, de Leon AC, Henry EL, Fedderly BJ, Freed MD, et al. Guidelines for the management of patients with valvular heart disease executive summary a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). Circulation. 1998;98(18):1949-84. 3. Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G, et al. Guidelines on the management of valvular heart disease: The task force on the management of valvular heart disease of the European Society of Cardiology. Eur Heart J. 2007;28(2):230-68. 4. 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References Conclusion Our systematic review of randomized studies, which evaluated the outcomes of patients who randomly received biological and mechanical valve prostheses, showed that although there are no differences in mortality, there is a significant increase in the risk of new valve replacement surgery when opting for biological prostheses. In contrast, the risk of bleeding is lower with bioprostheses. There were no differences in mortality, the risk of endocarditis or systemic embolism between the two prosthesis types. Although three of the four trials included in our meta-analysis used old generation biological and mechanical prostheses, the trial which evaluated currently used prostheses for aortic valve replacement showed the same results. Nevertheless, evidence to inform the choice between currently available prostheses is very limited and mostly based on observational studies. Randomized comparisons are utterly necessary. Author contributions Conception and design of the research: Kiyose AT, Moises VA, Cavalcanti AB; acquisition of data: Kiyose AT, Suzumura EA, Laranjeira L, Buehler AM, Santo JAE, Moises VA, Cavalcanti AB; analysis and interpretation of the data and writing of the manuscript: Kiyose AT, Moises VA, Cavalcanti AB; statistical analysis: Kiyose AT, Buehler AM, Moises VA, Cavalcanti AB; obtaining funding: Moises VA; critical revision of the manuscript for intellectual content: Kiyose AT, Berwanger O, Carvalho ACC, Paola AA, Moises VA, Cavalcanti AB. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by Capes. Study Association This article is part of the thesis of master submitted by Alberto Takeshi Kiyose, from Universidade Federal de São Paulo – Escola Paulista de Medicina. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 300