RESILIA data widens tissue valve options for younger patients

Awareness and price still slow adoption as durability evidence challenges mechanical valve trade-offs.

Longer-term RESILIA data is giving surgeons more confidence to consider bioprosthetic valves for younger heart valve patients, although awareness and price remain barriers to wider adoption.

Speaking in an interview during the RESILIA Summit, Prof. Dato’ Dr. Jeffrey Jeswant Dillon, Senior Consultant Cardiothoracic Surgeon at Institut Jantung Negara, said the 10-year COMMENCE data showed strong durability for RESILIA-based bioprosthetic valves.

He said the findings have affected how clinicians assess the age threshold for choosing a bioprosthetic valve over a mechanical valve. Mechanical valves have traditionally been considered for younger patients because of durability, but they usually require lifelong anticoagulation therapy.

With stronger 10-year data, Dillon said younger patients may be more confidently advised to consider a bioprosthetic valve where appropriate.

Wider adoption still faces two main barriers. The first is public awareness, particularly because RESILIA remains a newer technology that needs to be backed by strong clinical results. Dillon said sharing the 10-year COMMENCE findings could help broaden understanding amongst patients and clinicians.

The second barrier is cost. Dillon said newer valve technology carries a price premium compared with conventional bioprosthetic and mechanical valves, although he expects prices to fall over time as utilisation increases.

Treatment decisions are still guided by both international and local evidence. Dillon said international studies remain the benchmark where local data is not readily available, but local findings can strengthen confidence because disease patterns may differ by market.

Durability and future valve-in-valve options are also changing how surgeons view bioprosthetic valves. Dillon said a durable first valve, combined with the possibility of a later transcatheter procedure if the valve fails, creates a stronger pathway for patients.

For clinicians, the test is whether durability data and valve-in-valve options can offset awareness and pricing barriers as tissue valves are considered for younger patient groups.