Alkhouli M, Alqahtani F, Simard T, et al. - Researchers used a national representative database to determine independent predictors of mechanical valve use, as well as the results of bioprosthetic vs mechanical valve replacement in the United States. From the Nationwide Inpatient Sample, hospitalizations for aortic valve replacement (AVR) or mitral valve replacement (MVR) were selected. Female gender, prior sternotomy, prior defibrillator, and South/West geographic location, all were revealed as predictors of mechanical valve use, in multilogistic regression analyses. A negative predictor of mechanical AVR was bicuspid valve presence, whereas mitral stenosis was identified to be related to higher mechanical MVR. With AVR but not with MVR, a decrease in unadjusted in‐hospital mortality was seen over time, irrespective of prosthesis choice. Findings demonstrated a substantial decrease in the use of mechanical valve replacement in patients aged ≤ 70 years in the US. To better describe the future role of mechanical valves in this age group, there is a requirement of long‐term durability data on bioprosthetic valve replacement.