Hu X, Jiang W, Xie M, et al. - In order to determine the optimal valve prosthesis in mitral valve replacement (MVR) for infective endocarditis (IE), particularly for younger patients, researchers examined whether there are differences in postoperative outcomes of mechanical and biological MVR in IE patients aged 50 to 69 years. Among all IE patients aged 50 to 69 years with primary MVR in Hubei province hospitals from 2002 to 2018, they retrieved 492 patients with comparable baseline features between bioprostheses and mechanical prosthetic valve groups using propensity score matching (1:3 ratio). The mechanical valve group had 15‐year survival of 80.6% after MVR vs 69.3% in the bioprostheses group. Observations suggest better survival, lower rates of reoperation in correlation with mechanical valve prostheses vs bioprostheses within 15 years after MVR in IE patients aged 50 to 69. These findings favors using mechanical valve prostheses as an alternative to bioprostheses in this patient group.