Bioprosthetic heart valves removed 76 to 150 months after implantation were morphologically investigated to correlate structural alterations with clinical failure modes. Traditional morphologic methods of evaluating valvular heterografts, such as microradiography and electron microscopy, were complemented by undecalcified ground sections, a new technique for analyzing the distribution of mineral deposits. Apart from well-investigated mechanisms that accelerate tissue degeneration, our observations point to additional facts: (1) phagocytosis of collagen fibrils and elastic material by macrophages and foreign body giant cells in areas near tears and perforations and (2) initial calcification indicated by delicate crystals in the intercellular space arranged in close relation to the periodicity of the cross-striation pattern of collagen fibrils. The present report not only calls attention to degenerative changes that are enhanced by mechanical stress but also underlines phagocytosis as an important mechanism in the destruction of bioprosthetic heart valves.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Total autologous reconstruction of the right and left ventricular outflow tracts: the case for the modified Ross-Ozaki procedure.
Multimed Man Cardiothorac Surg
January 2025
Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University Mansoura, Egypt.
The Ross procedure continues to be the best procedure to address unrepairable aortic valve pathology, especially in young adults. The Achilles heel of this procedure has been aortic root dilation and the potential need for a reoperation that may be associated with slightly increased risks in addition to the need for intervention on the pulmonary outflow tract. Modifying the Ross procedure by autograft inclusion inside a Dacron graft seems to have the potential advantage of stabilizing the autograft diameter, which may be associated with improved durability and decrease the need for future intervention.
View Article and Find Full Text PDFSevere aortic valve stenosis poses a significant risk for the aging population, often escalating from mild symptoms to life-threatening heart failure and sudden death. Without timely intervention, this condition can lead to disastrous outcomes. The advent of transcatheter aortic valve implantation (TAVI) has gained popularity, emerging as an effective alternative for managing severe aortic stenosis (AS) in high-risk patients experiencing deterioration of previously implanted bioprosthetic surgical aortic valves (SAV), which introduces complex challenges such as device compatibility and anatomical considerations.
View Article and Find Full Text PDFIncidence and Outcomes of Prosthetic Valve Endocarditis in Adults with Congenital Heart Disease.
Am Heart J
January 2025
Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN 55905. Electronic address:
Background: Patients with congenital heart disease (CHD) often require prosthetic valve implantation, increasing their lifetime risk of developing prosthetic valve endocarditis (PVE). The purpose of this study was to determine the incidence, risk factors, and outcomes of PVE in adults with CHD.
Method: Retrospective cohort study of adults with CHD and prior prosthetic valve implantation (2003-2023).
Hemodynamic Valve Deterioration After Transcatheter Aortic Valve Replacement: Incidence, Predictors, and Clinical Outcomes.
JACC Cardiovasc Interv
January 2025
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address:
Background: Reports on the durability of transcatheter aortic valve replacement (TAVR) prostheses are scarce and confounded by varying definitions and competing risks of death.
Objectives: The authors sought to determine the incidence, predictors, and clinical outcomes of hemodynamic valve deterioration (HVD) according to the Valve Academic Research Consortium 3 definition after TAVR.
Methods: We analyzed consecutive patients undergoing TAVR in the prospective Bern TAVI (Transcatheter Aortic Valve Implantation) registry between August 2007 and June 2022 for the incidence and predictors of HVD and performed case control-matching to compare outcomes according to HVD.
Clinical Characteristics and Outcomes of Patients Undergoing 3 Aortic Valve Interventions: The THIRD Multicenter Registry.
JACC Cardiovasc Interv
January 2025
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
Background: Lifetime treatment of aortic valve disease is a matter of increasing debate. Although the risks of a second aortic valve intervention are recognized, little attention has been given to the challenges of a third.
Objectives: This study delves into the clinical characteristics, indications, and outcomes of patients undergoing 3 aortic valve interventions.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!