AI Article Synopsis
- Understanding the different ways bioprosthetic valves can fail is essential, as more patients will be experiencing these issues over time.
- Recent findings highlight the importance of monitoring these valves with regular echocardiograms to assess performance and recognize degeneration types, including structural and nonstructural failures.
- More research is needed to identify factors that contribute to early valve failure to enhance patient outcomes and prolong the lifespan of these implants.
Article 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.
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| http://dx.doi.org/10.1097/HCO.0000000000000711 | DOI Listing |
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