Structural valve deterioration and mode of failure of stentless bioprosthetic valves

Aortic stentless bioprosthetic valve (SLBPV), either porcine or pericardial, minimizes transvalvular gradient and favors regression of left ventricular hypertrophy. The drawback consists longer time for suturing. While structural deterioration (SVD) in stented pericardial BPVs has been extensively investigated, less information is available on SLBPVs. We studied 82 SLBPVs explants, (Toronto SPV, [St. Jude Medical, MN, USA], CryolifeO'Brien Model 300 CryoLife-O'Brien [Cryolife International, GA, BioCor PVS USA] Prima Plus [Edwards Lifesciences Corp. One Edwards Way, CA, formerly Baxter Inc, USA]) ([Pericarbon Freedom Solo [Sorin-Biomedica, S.p.A., Saluggia, Italy]). By excluding cases with leak endocarditis, we focused the investigation 46 SLBPVs, which failed because SVD. Gender was male 29 (63%). Mean age patients at implant 59.8 years. Postoperative SVD 115.0 months 79.0 Dysfunction requiring reoperation mainly incompetence stenosis Even pinpoint mineralization commissures resulted sudden cusp tearing incompetence. Cuspal atheromasia accounted even absence calcification. Mineralization showed progression but not Tissue remains nightmare also peculiar features calcific deposits commissures, abrupt massive cuspal