Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Mar;35(2):123-132.
doi: 10.1097/HCO.0000000000000711.

Modes of bioprosthetic valve failure: a narrative review

Alex Koziarz  1 , Ahmad Makhdoum, Jagdish Butany, Maral Ouzounian, Jennifer Chung
Affiliations
Review

Modes of bioprosthetic valve failure: a narrative review

Alex Koziarz et al. Curr Opin Cardiol. 2020 Mar.

Abstract

Purpose of review: A thorough understanding of the modes of bioprosthetic valve failure is critical as clinicians will be facing an increasing number of patients presenting with failed bioprostheses in coming years. The purpose of this article is to review modes of bioprosthestic valve degeneration, their management, and identify gaps for future research.

Recent findings: Guidelines recommend monitoring hemodynamic performance of prosthetic valves using serial echocardiograms to determine valve function and presence of valve degeneration. Modes of bioprosthetic valve failure may be categorized as structural degeneration (calcification, tears, fibrosis, flail), nonstructural degeneration (pannus), thrombosis, and endocarditis. Calcification is the most common form of structural valve degeneration. Predictors of bioprosthetic valve failure include valves implanted in the mitral position, younger age, and type of valve (porcine versus bovine pericardial). Failed bioprosthetic valves are managed with either redo surgical replacement or transcatheter valve-in-valve implantation.

Summary: Several modes of bioprosthetic valve failure exist, which vary based on patient, implant position, and valve characteristics. Further research is required to characterize factors associated with early failure to delay structural valve degeneration and improve patient prognosis.

PubMed Disclaimer

References

    1. Maganti K, Rigolin VH, Sarano ME, Bonow RO. Valvular heart disease: diagnosis and management. Mayo Clin Proc 2010; 85:483–500.
    1. D’Agostino RS, Jacobs JP, Badhwar V, et al. The society of thoracic surgeons adult cardiac surgery database: 2016 update on outcomes and quality. Ann Thorac Surg 2016; 101:24–32.
    1. David TE, Ivanov J, Armstrong S, et al. Late results of heart valve replacement with the Hancock II bioprosthesis. J Thorac Cardiovasc Surg 2001; 121:268–278.
    1. Jamieson WE, Ling H, Burr LH, et al. Carpentier-Edwards supraannular porcine bioprosthesis evaluation over 15 years. Ann Thorac Surg 1998; 66: (6 Suppl): S49–S52.
    1. Burdon TA, Miller DC, Oyer PE, et al. Durability of porcine valves at fifteen years in a representative North American patient population. J Thorac Cardiovasc Surg 1992; 103:238–251.