Bioprosthetic valve complications

Valve replacement is not a curative procedure but introduces a new disease process with prosthetic valve-related complications. Structural valve deterioration is a clinically important long-term complication of bioprosthetic valves, causing stenosis, regurgitation or a combination of both, ultimately necessitating reintervention Other complications of patients with prosthetic valves include late-onset atrial fibrillation and endocardial infection. Patients with prosthetic valves, especially those in the mitral position, are at higher risk for atrial fibrillation for the rest of their lives

Prosthetic heart valves: Part 4 - Complications and

vular regurgitation, bioprosthetic valves, echocardiography, Doppler studies Introduction Valve-related complications lead to reoperation or cause death in a significant number of patients with prosthetic valves within 10 years of valve insertion.' One of the major compli- cations of prosthetic valves is intravascular hemolysis. In 1975 Complications include embolic events, bleeding, valve obstruction (due to thrombosis or pannus), infective endocarditis, structural deterioration (particularly for bioprosthetic valves), paravalvular regurgitation, hemolytic anemia, and patient-prosthesis mismatch The most important cause of prosthetic valve thrombosis is inadequate anticoagulation, which is more common with mechanical valves, but thrombosis can occur with bioprostheses long after implantation [ 23, 26, 27 ]. Pannus formation is a chronic complication after AVR, caused by fibrous tissue ingrowth around the prosthetic valve

Complications of Prosthetic Heart Valves in the Emergency

Prosthetic Heart Valves Circulatio

Nevertheless, some authors report that there is no advantage in either survival or quality of life for patients 65-75 years of age receiving a bioprosthetic or mechanical valve. [ 5] Complications.. Mechanical heart valves also have disadvantages. The blood flow around a mechanical heart valve is at higher stress then a bioprosthetic valve that can lead to blood clotting abnormality and potentially development of clot on the valve Abnormal flow patterns have been shown to normalize with placement of some mechanical valves such as the On-X valve (On-X Life Technologies, Austin, Tex) but persist with bioprosthetic valves , and insight into this difference may potentially play a role in understanding the development of complications Mitral bioprosthetic valve stenosis in a patient with antiphospholipid antibody syndrome and systemic lupus erythematosus. Morisaki A(1), Hirai H, Sasaki Y, Hosono M, Sakaguchi M, Nakahira A, Seo H, Suehiro S. Mitral Valve Stenosis/complications* Prosthesis Failure/adverse effects Aortic valve replacement with bioprostheses in young adults is associated with high structural valve deterioration and reintervention rates and low, though not absent, hazards of thromboembolism and bleeding

Bioprosthetic heart valves: modes of failur

  1. The main risk with bioprosthetic valves is reoperation for SVD due to the limited durability of bioprosthetic valves (Figure 1).The average lifespan of a bioprosthetic valve is estimated at 15 years in elderly patients, but this risk is higher in younger patients in whom SVD is accelerated due to a more pronounced immunologic response to the valve and enhanced calcification of the valve. 16.
  2. Bioprosthetic structural valve degeneration with cusp prolapse Due to the high risk of complication from a repeat sternotomy, pre-procedural cardiac CT was performed prior to consideration for valve-in-valve TAVI in a patient with a bioprosthetic aortic valve replacement (19 mm Pericardial Elan, Vascutek)
  3. For bioprosthetic valves, the risk of repeat surgery was greater but the incidence of major bleeding was lower. These complications include primary valve failure, prosthetic valve endocarditis (PVE), prosthetic valve thrombosis (PVT), thromboembolism, and mechanical hemolytic anemia. In addition, because many of these patients require long.
  4. Mechanical failure of the delivery catheter system and/or accessories may result in patient complications. Transcatheter aortic valve (bioprosthesis) Accelerated deterioration due to calcific degeneration of the bioprostheses may occur in: children, adolescents, or young adults; patients with altered calcium metabolism (e.g., chronic renal.
  5. Bioprosthetic Valve Complications. -calcification and/or degeneration (with age) -all bioprosthetic valves are inherently stenotic. -stenotic degree depends on type, size, site: recommended valve area and pressure gradient are always to be calculated with every echo!! -the data will be available for comparison. -utilize manufacture's statistics
  6. A presentation from the Prosthetic valves under the spotlight session at EuroEcho-Imaging 2018 In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled
  7. (2019). Complications of Bioprosthetic Valve Fracture as an Adjunct to Valve-in-Valve TAVR. Structural Heart: Vol. 3, No. 2, pp. 92-99

Bioprosthetic Valves in terms of Perioperative Complications in Redo-Valve Surgeries . Saqib Anwar . CTS Section, Aga khan University hospital, Pakistan . ABSTRACT: Mechanical andBioprosthetic valves were in terms of compared longer ICU stay, mortality Prosthetic valves Types Selection Complications Types Bioprosthetic valves. DESPITE continuing advances in cardiac valve surgery, it remains clear that valve replacement with any prosthesis is a palliative and not a curative procedure. 1 Every patient with an artificial heart valve is subject to an ongoing risk of a variety of complications that vary with different prostheses but that are common to most. Follow-up studies report that nearly half of all patients. orrhagic complications. Perspective Given consistent durability, use of bio-prostheses for aortic valve replacement in valve (ie, the bioprosthesis in the aortic position) or to another device, eventually leading to exclusion of the selected event from the present analysis. Cerebral or noncerebral systemic thromboembolic events wer February 28, 2020. Though rare, bioprosthetic valve thrombosis (BPVT) is associated with both a recurrence of BPVT and early prosthetic degeneration, according to a new analysis. Treatment with anticoagulation seems to improve the long-term outcomes of patients with BPVT, but it can cause an increase in bleeding

Anticoagulation Strategies After Bioprosthetic Valve

Tissue [bioprosthetic] valves -include homograft / allografts There is a higher rate of thrombotic and thromboembolic complications with mechanical heart valves The impact of HALT/HAM on thromboembolic complications and structural valve L. et al. Natural history of subclinical leaflet thrombosis affecting motion in bioprosthetic aortic valves This document included the list of OPC for valve-related complications (Table 1). The OPC are estimates of the average complication rates, based on the reports of previously approved heart valves. Current Implementation of OPC A new heart valve must be shown to have complications rates that are equivalent to the OPC


Nevertheless, some authors report that there is no advantage in either survival or quality of life for patients 65-75 years of age receiving a bioprosthetic or mechanical valve. Complications. -Mitral, older gen mech aortic valve (ball in cage), or aortic valve with risk factors for VTE — 3.0 -Antiplatelet therapy with low dose ASA is recommended for those with a mechanical prosthesis and for pts with a bioprosthesis

Prosthetic Heart Valves - Symptoms, Types, Advantanges

Anticoagulation for Valvular Heart Disease - American

Data were extracted from 19 Food and Drug Administration summaries of safety and effectiveness data reports (31 series) and 56 literature articles (85 series) published from 1999 to 2012. The OPC were calculated for five valve-related complications by valve type (mechanical and bioprosthetic) and valve position (aortic and mitral) A prospective study 17 assessing the efficacy of ticlopidine on thromboembolism included 235 patients with valve repair or bioprosthetic valve replacement in aortic, mitral, or tricuspid position. The authors concluded that ticlopidine seemed to prevent thromboembolism better than other therapy based on 2 and 4 thromboembolic events, respectively Bioprosthetic Valve Stenosis. Bioprosthetic valve stenosis is a condition that in some cases necessitates the use of prosthetic tissue valves to replace the native aortic, mitral, tricuspid or pulmonic valves when they stop competently functioning. These valves are made from pig or cow tissue and typically have a lifespan of 10-15 years [Mitral valve replacement with bioprosthesis in children]. [Article in French] Mostefa-Kara M, Blin D, Langlet F, Mouly A, Goudard A, Montiès JR. Forty seven bioprostheses were used for mitral valve replacement between January 1975 and June 1980, with no operative mortality, in children under 19 years of age Bioprosthetic heart valves (BPHVs) have fundamentally changed the treatment of valvular heart disease. Despite the continuous progress of BPHVs, from early valve designs for use in surgical replacement to the rapidly evolving use of transcatheter replacement techniques and designs, valve dysfunction and degeneration remain fundamental issues

Valve-in-valve procedures offer an alternative to repeat surgery, since the replacement valve is inserted inside the failing surgical bioprosthetic valve through a patient's blood vessel or a. Surgical or TAVR Bioprosthetic Valve Failure: Preprocedural Planning, Best Practice Steps, and Complications. Presenter: Keith Allen. July 20, 2021. REGISTER for free or LOG IN to view this content. TVT 2021. Aortic Valve. Up Next. Presentation TVT 2021. TEER Procedural Guidance: Standard and Emerging Imaging Tools Two dimensional echocardiographic assessment of patients with bioprosthetic valves. Schapira JN, Martin RP, Fowles RE, Rakowski H, Stinson EB, French JW, Shumway NE, Popp RL. The clinical utility of two dimensional echocardiography in assessing bioprosthetic and left ventricular function was studied in 40 consecutive patients 1 week to 60. Bioprosthetic valve patients, on the other hand, were more fearful of the need for reoperation. Nevertheless, with a 10-year freedom rate from all valve-related complications of 90% for mechanical valves versus 83% for bioprostheses (P = 0.01). Based on this published data and that presented herein, it appears that the use of a mechanical. Introduction: Valve-in-valve TAVR (ViV-TAVR) is an established treatment for failing surgical aortic valves in patient at high surgical risk. Elevated transprosthetic gradients are common after ViV-TAVR. Previously, bench tests showed feasibility of bioprosthetic valve fracturing (VF) using high-pressure balloons. Small case series show reduced transprosthetic gradients using VF

Bioprosthetic valves have a low long-term thromboembolic risk and therefore do not require lifelong anticoagulation. The choice of bioprosthetic valve, when compared to mechanical valves, may be appealing in older patients and those with higher risk of complications from anticoagulation. 24. However, in the first bioprosthetic valve because of massive regurgitation. He devel - oped permanent heart block as a complication of cardiac surgery that required permanent pacing accomplished by epicardial PM implantation with lead positioning through a left mini-thoracot - omy. Because of recurrent malignant ventricular arrhythmias per B. F. Waller et al.: Catheter balloon valvuloplasty of bioprosthetic valves 769 FIG. 9 cornpeterit prosthetic valve (right). Frames from videorecorder showing marked disruption and dislodgement of degenerative cusps leaving a wide-open,'' in- TABL~ IV Catheter balloon valvuloplasty of operatively ex- cised ateiiotic porcine bioprosthetic valves: Results of dilation Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) has been established as a safe and effective means of treating failed surgical bioprosthetic valves (BPVs) in patients at high risk for complications related to reoperation. Patients who undergo VIV TAVR are at risk of patient-prosthesis mismatch, as the transcatheter heart. We evaluated the efficacy and safety of direct oral anticoagulants (DOACs) in patients who received a bioprosthetic valve replacement. In this cohort of patients, similar rates of thromboembolic complications and major bleeding events in patients receiving a DOAC or warfarin within 6 months of receiving a bioprosthetic valve replacement were seen

The rates of 203 all-cause death and stroke or systemic embolism were similar between the two groups. 204 Anticoagulation strategies for patients with bioprosthetic valves and atrial fibrillation is 205 complicated since bioprosthetic valves and atrial fibrillation cause thromboembolic 206 complications with different mechanisms [18] The Edwards Pericardial Mitral Bioprosthesis, Model 11000M, is a stented trileaflet valve comprised of RESILIA bovine pericardial tissue that is mounted on a flexible frame. The valve is stored under dry packaging conditions and consequently does not require rinsing prior to implantation. The valve is available in sizes 25, 27, 29, 31 and 33 mm However, patients with bioprosthetic valves and, in particular, bioprosthetic MVs were limited. The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial had 31 such patients, and the Effective Anticoagulants with Factor Xa Next Generation AF had 131 Increasingly sAS is being diagnosed earlier, with more people receiving valve replacement at a younger age. 3 Most bioprosthetic valves are free from deterioration for up to 15 years and — although many patients have an increased life expectancy due to the initial valve intervention — the valve may need to be replaced at some point. 4 ViV TAVI has been shown to be a viable alternative to.

Complications of Prosthetic Heart Valves in the Emergency

Bioprosthetic valve thrombosis (BPVT) is an important clinical entity eventually following both bioprosthetic surgical and transcatheter aortic valve replacement. Although the thrombogenicity of bioprosthetic heart valves appears to be much lower than in mechanical heart valves, recent studies show that valve or leaflet thrombosis following. These complications could lead to reoperation, explant of the bioprosthesis, permanent disability, or death. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For a listing of indications, contraindications, precautions, warnings, and potential adverse events, please refer to the Instructions for Use Although bioprosthetic aortic valves are less durable than their mechanical counterparts, they are increasingly used because of mechanical valves' requirement for lifelong anticoagulation with its accompanying risk of bleeding complications. Nevertheless, the durability of the various bioprosthetic valves used clinically is unknown

Regardless of the type of prosthetic valve implanted, approximately one-third of patients die of valve-related causes. Given that valve-related complications occur at a frequency of about 3% to 6% per year, it is important to ask if the risks in a specific patient may be minimized by the choice of a mechanical vs a bioprosthetic valve Stented bioprosthetic valves, which incorporate a semi-rigid external support structure for the valve leaflets, represent the majority of tissue valves implanted in clinical practice. The external support provides accurate valve mounting, improving ease of implantation. long-term survival and low incidence of valve-related complications Bioprosthetic valve fracture (BVF) is a method to facilitate ViV TAVR in which the surgical valve ring is fractured with high-pressure balloon inflation, allowing for more optimal THV expansion, thus significantly improving postprocedural gradients and EOA. 7-9 The safety and efficacy of BVF have been demonstrated in multiple case series Commercial heart valve companies have sought to promote the utilization of third-generation bioprosthetic valves by promising diminished residual gradients and improved tissue durability.[11,18,20] Several factors complicate the comparison of early hemodynamic performance among devices, including heterogeneity of commercial valve sizers. Historically, Valve Replacement type is chosen based on age. Mechanical Heart Valves (Artificial Heart Valves) for younger patients (age <60 years). More short-term complications in first 1-2 decades (bleeding and Thromboembolism risk); Requires Anticoagulation. See Anticoagulation after Heart Valve Replacement; Bioprosthetic Heart Valves (biologic Heart Valves) for older patients (age >70 years

Cardiac complications occurred in 10 pregnancies (20%) in the women with mitral mechanical valves and four (13%) with mitral bioprosthetic valves (RR 1.55, 95% CI 0.53-4.52). All four thromboembolic complications with mechanical valves occurred in the 14 women treated with heparin throughout pregnancy They need emergent valve replacement. Adjunctive therapy may be initiated while these arrangements are being made. A less dramatic presentation of valvular failure may be seen in patients with valve thrombosis or in those with more gradual deterioration of bioprosthetic valves (see Thromboembolic complications) Paravalvular aortic root abscess with intracardiac fistula formation is an exceedingly rare complication of infective endocarditis. This condition is even more rarely encountered in patients with bioprosthetic valve endocarditis. We report an unusual case of a 68-year-old Bosnian female with a bioprosthetic aortic valve, who developed an extensive aortic root abscess, complicated by an aortico. Tissue valves are created from animal donors' valves or animal tissue that's strong and flexible. Tissue valves can last 10 to 20 years, and usually don't require the long-term use of medication. For a young person with a tissue valve replacement, the need for additional surgery or another valve replacement later in life is highly likely

An artificial heart valve is a one-way valve implanted into a person's heart to replace a valve that is not functioning properly (valvular heart disease).Artificial heart valves can be separated into three broad classes: mechanical heart valves, bioprosthetic tissue valves and engineered tissue valves With the INSPIRIS RESILIA valve, to achieve area expansion, there is no need for a high-pressure bioprosthetic valve fracture (BVF) to expand the valve. BVF is associated with risk of stroke and other complications in valve-in-valve patients when used to crack a valve.2 VFit technology delivers predictable, controlled valve expansion This newly-developed mitral valve bioprosthesis, named SingValve, mimics the appearance, form and physical properties of a human mitral valve. This promises fewer complications and prolongs. After aortic valve surgery, the structural failure rate is higher for bioprosthetic valves than for mechanical valves among patients less than 65 years of age . However, this difference disappears in patients greater than 65 years of age, with bioprosthetic valves and mechanical valves having similar low rates of structural failure Prevention of prosthetic complications (anticoagulation, endocarditis prophylaxis, echocardiographic monitoring) Although new anticoagulants are now approved for the treatment of lone atrial fibrillation, warfarin remains the sole recommended anticoagulant for patients with mechanical heart valves [].In patients with bioprosthetic heart valves, most centers still recommend traditional warfarin.

Mitral stenosis - Types, Causes, Symptoms, Diagnosis and

cades.2 Bioprosthetic heart valve (BPHV) replace-ments have significant advantages over mechanical cardiac valve prostheses in terms of a reduced risk for thromboembolic complications; however, they fre-quently fail clinically because of material deterioration and associated calcium phosphate deposits3-5 a New results suggest that while the bioprosthesis may begin to degenerate at around the seven-year mark, valve-related complications are rare, even out to 20 years. (Eichinger WB et al. Ann Thorac.

Transcatheter heart valve implantation for failing

Prosthetic Valve Dysfunction - an overview ScienceDirect

valve-related complications. MATERIALS AND METHODS Study population The study population consisted of 104 patients who underwent TVR with or without concomitant surgical procedures between February 1991 and December 2009 at the Asan Medical Center in Korea. Forty-five bioprosthetic valves (43%) and 59 mechanical valves (57%) were implanted Frequent long-term complications were stroke (9.2%) and bleeding (4.8%), with bleeding complications being higher in the mechanical valve group (p = 0.009). During the follow-up period biological valves showed a numerically higher survival rate during the first years, which shifted after 3 years in favour of mechanical valves

Evaluation of hemolysis in patients with prosthetic heart

Two types of prosthetic valves are used for heart valve replacement surgery - mechanical or bioprosthetic. Mechanical valves have long-term durability, but require lifelong anticoagulation, with the risk of thrombosis, thromboembolism, or spontaneous bleeding and are therefore less than ideal, particularly in younger patients, pregnant patients. Complications. When a degenerated bioprosthetic valve doesn't open and close properly, the heart must work harder to push blood through the aorta. This weakens the heart and increases the risk of heart failure. Structural Heart and Valve Doctors at Baptist Health It should be noted that the risk of reoperation is not limited to bioprosthetic valves; reoperation can also occur with mechanical valves, due to valve thrombosis or valve dehiscence. Chikwe et al. [ 16 ] recently reported that the cumulative incidence of mitral valve reoperation at 15 years was 11% in the bioprosthesis group and 5% in the.

Complications after aortic valve repair and valve-sparingMon 12-05-2005 OS Lecture 5 - Valve Disease Stenotic - Dr

Aim. The aim of the study was to assess the functional status, performance and complications of bioprosthetic valves implanted in forty five consecutive patients at All India Institute of Medical Sciences, New Delhi between January 2000 and September 2001. Method. The preoperative, operative and postoperative data were collected from case records and at follow up Although older patients may be opted for a bioprosthetic valve to avoid complications with anticoagulation, the development of atrial fibrillation in the same demographic may effectively cancel any benefit of this management approach. The delivery method of the prosthetic valve (surgical vs. transcatheter) should also play a role in the.

Complications of prosthetic heart valves SpringerLin

Abstract. Recent technological advances have led to a proliferation of prosthetic heart valves, primarily for the treatment of mitral and aortic disease. Cardiac auscultation can be a powerful tool to differentiate the various types of mechanical and bioprosthetic valves, to identify prognostic factors, and to diagnose complications N2 - Our objective was to determine the relative merits of using a bioprosthetic porcine valve (BPV) versus a mechanical valve (MechV) when tricuspid valve (TV) replacement is required in patients with Ebstein anomaly. From 1972 to 2006, 333 patients received a BPV and 45 received a MechV

efficacy of valve-in-valve transcatheter aortic valve replacement (ViV TAVR) as an alternative to reoperation for patients with failed bioprosthetic surgical valves (BSVs). These data have led to the approv-al of ViV TAVR by the FDA for patients with a failed aortic bioprosthesis who are at high risk of complications related to reoperation.1, An acceleration of embolic complications occurred in porcine valve recipients from the 4th to the 5th postoperative years and corresponded with an acceleration in mitral bioprosthetic degeneration during the same time interval . The late (>three years) occurrence of these emboli despite warfarin anticoagulation in 73 percent of mitral porcine. The Edwards SAPIEN 3 Transcatheter Heart Valve System and Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System are indicated for patients with symptomatic heart disease due to failure (stenosed, insufficient, or combined) of a surgical bioprosthetic aortic or mitral valve who are judged by a heart team, including a cardiac surgeon, to be at. Bioprosthetic valve fracture together with ViV TAVI is a safe and effective emerging technique for treatment of small surgical aortic bioprosthesis failure. Bioprosthetic valve fracture allows marked oversizing of implanted self-expandable transcatheter aortic valves, leading to excellent haemodynamic and clinical results