What is the primary concern with long-term mechanical valves?

The primary concern with long-term mechanical valves is the requirement for long-term anticoagulation. Mechanical heart valves are made from materials that can potentially trigger a clotting response in the body. To mitigate the risk of thrombus formation, patients with mechanical valves must be placed on anticoagulants, such as warfarin, indefinitely. This long-term anticoagulation management is crucial for preventing serious complications such as stroke or systemic embolism.

While structural failure and infective endocarditis are important issues associated with mechanical valves, they are less common than the ongoing need for anticoagulation. Mechanical valves are designed to be durable and often outperform biological valves in terms of longevity, thus addressing durability concerns. However, the necessity of lifelong anticoagulation presents a significant challenge in patient management, making it a primary concern unique to mechanical valves.