Question: Up to what age is it advisable to replace a biological heart prosthesis a second time, even if the patient is in good physical and health condition? Pablo (Portugal).
Answer: As you can imagine, undergoing a reoperation always means increasing the risk of surgery. Although classically an age above 80 years was set as the border, technical advances in cardiac surgery, as well as greater experience in certain procedures, make that limit today not seem so clear. In fact, very good results have recently been published in cardiac surgery in patients above that age. Therefore, the decision will depend a lot on the patient's conditions, the surgeon's experience and the resources available to him at his center. Additionally, in cases of patients rejected for conventional surgery, there is the option of implanting the prosthesis percutaneously or transapically (TAVI).