Modern understanding of mechanisms of bioprosthetic valve structural degeneration: a literature review

Abstract

Bioprosthetic valves are often used to replace diseased heart valves. They differ from mechanical valves by optimal hemodynamic parameters and low thrombogenicity. However, although the durability of modern bioprosthetic valves, their design, and implantation procedures are being improved, the replacement of the native valve does not necessarily lead to favorable outcome, because valvular defect is often replaced by “prosthetic valve disease”. Structural valve degeneration is one of the main causes of bioprosthetic valve failure, but its mechanisms have not been studied in detail. This review summarizes and analyzes current data on mechanisms responsible for bioprosthetic valve structural degeneration. These mechanisms include passive degeneration, inflammation, fibrosis and osteogenesis.