The in Vivo Durability of Bioprosthetic Heart Valves-Modes of Failure Observed in Explanted Valves

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Abstract
This paper describes the results of a detailed investigation of 59 explanted bioprosthetic heart valves. The mean time of implantation was 5 years 9 months with 84 per cent of the valves implanted for more than 2 years 6 months. Valves were subjected to gross examination, radiography, and hydrodynamic testing prior to dissection and histological studies in order to establish the primary cause of failure or dysfunction. Typical failure modes were determined for the major types of bioprosthesis studied. The factors influencing bioprosthetic valve dysfunction are discussed.