Bioprosthetic valve degeneration
Bioprosthetic valve degeneration causes prosthetic valve failure like prosthetic valve thrombosis and pannus formation. Host related factors which predispose to bioprosthetic valve degeneration are:
- Younger age – hyperdynamic circulatory state in the young increases hemodynamic trauma
- Ejection fraction
- High blood pressure – increases hemodynamic load on the valve
- Chronic renal disease
- Diabetes mellitus
- Dyslipidemia – enhances deposition of oxidized LDL on the valve leaflets
Valve related factors which cause bioprosthetic degeneration are the type of valve and correctness of implantation. Incorrectly implanted valve is likely to degenerate faster due to hemodynamic trauma.
Bioprosthetic structural degeneration is associated with calcium deposition, immunological reaction, infiltration of oxidized LDL (low density lipoprotein cholesterol) and foam cells causing atherosclerosis in the leaflets.