Prosthetic valve selection for middle-aged patients with aortic stenosis

Prosthetic aortic valves are often required for patients with aortic stenosis. The optimal choice of valve in middle-aged patients is not clear and the available options all have drawbacks. Patient choice is the most important factor in deciding which valve to use, with biological valves increasingly favored over mechanical valves. The authors of this Review present the various prosthetic aortic valves currently in use and discuss the implications of prosthesis selection in this group of patients.