Black patients undergoing aortic valve replacement face significantly higher rates of serious complications and death compared to white patients, according to research analyzing nearly 6,000 surgical cases nationwide. The findings reveal persistent inequities in cardiovascular care that extend beyond surgical technique to reflect deeper structural and socioeconomic barriers.
Among patients who received either mechanical or bioprosthetic valve replacements, Black patients experienced elevated rates of cardiac arrest, prolonged mechanical ventilation, blood clots, acute kidney failure, and death within 30 days of surgery. Even after researchers adjusted for clinical factors like age and preexisting conditions, Black race remained an independent predictor of severe postoperative complications.
The disparities began before surgery. Black patients presented with substantially higher burdens of heart failure, hypertension, and kidney disease. They were younger on average but sicker, suggesting delays in diagnosis or treatment access. Among those under 60, Black patients were more than twice as likely to undergo the Ross procedure, a complex operation that uses the patient’s own tissue, possibly because kidney disease made them poor candidates for mechanical valves requiring lifelong blood thinners.
Researchers emphasized these differences stem from structural inequities rather than biology. Factors like insurance coverage, referral patterns, distance to specialized centers, and preoperative optimization likely compound clinical risk. The study authors called for standardized referral pathways, enhanced patient education, and targeted efforts to reduce implicit bias in treatment decisions.
See: “Black Patients Experience Higher Complication Burden and Distinct Valve Selection Patterns in Aortic Valve Replacement” (January 30, 2026)
