Early Aortic Bioprosthetic Valve Deterioration in an Octogenarian

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Early Aortic Bioprosthetic Valve Deterioration in an Octogenarian Hironori Izutani, MD, PhD, Takanori Shibukawa, MD, Jun Kawamoto, MD, Shingo Mochiduki, MD, Dairoku Nishikawa, MD The Annals of Thoracic Surgery Volume 86, Issue 4, Pages 1369-1371 (October 2008) DOI: 10.1016/j.athoracsur.2008.03.064 Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Echocardiographic images of the aortic Perimount valve (Edwards Lifesciences, Irvine, CA) at diastolic phase (A) and systolic phase (B) showed bioprosthetic valve dysfunction with leaflet stiffness and motion restriction (arrows). There was severe aortic stenosis with a maximum flow of 4.6 m/sec (a maximum pressure gradient of 83 mm Hg) and an aortic valve area of 0.27 cm2. The Annals of Thoracic Surgery 2008 86, 1369-1371DOI: (10.1016/j.athoracsur.2008.03.064) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Autopsy findings of the explanted Perimount valve (Edwards Lifesciences, Irvine, CA) viewing from (A) outflow and (B) inflow. Gross examination revealed that the three leaflets were stiff with restricted motion, and the valve was stenotic. The Annals of Thoracic Surgery 2008 86, 1369-1371DOI: (10.1016/j.athoracsur.2008.03.064) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Microscopic examination of the explanted Perimount valve (Edwards Lifesciences, Irvine, CA) leaflet showed calcification deposits (intrinsic calcification) into the leaflet without inflammatory reaction. (Hematoxylin and eosin; ×100). The Annals of Thoracic Surgery 2008 86, 1369-1371DOI: (10.1016/j.athoracsur.2008.03.064) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions