Noncalcific Mechanisms of Bioprosthetic Structural Valve Degeneration

Autor: Matteo Marro, Alexander P. Kossar, Yingfei Xue, Antonio Frasca, Robert J. Levy, Giovanni Ferrari
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 3 (2021)
Druh dokumentu: article
ISSN: 2047-9980
DOI: 10.1161/JAHA.120.018921
Popis: Abstract Bioprosthetic heart valves (BHVs) largely circumvent the need for long‐term anticoagulation compared with mechanical valves but are increasingly susceptible to deterioration and reduced durability with reoperation rates of ≈10% and 30% at 10 and 15 years, respectively. Structural valve degeneration is a common, unpreventable, and untreatable consequence of BHV implantation and is frequently characterized by leaflet calcification. However, 25% of BHV reoperations attributed to structural valve degeneration occur with minimal leaflet mineralization. This review discusses the noncalcific mechanisms of BHV structural valve degeneration, highlighting the putative roles and pathophysiological relationships between protein infiltration, glycation, oxidative and mechanical stress, and inflammation and the structural consequences for surgical and transcatheter BHVs.
Databáze: Directory of Open Access Journals