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Standardized Definitions for Bioprosthetic Valve Dysfunction Following Aortic or Mitral Valve Replacement: JACC State-of-the-Art Review

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  • Heart Valve Collaboratory
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Bioprosthetic valve dysfunction (BVD) and bioprosthetic valve failure (BVF) may be caused by structural or nonstructural valve dysfunction. Both surgical and transcatheter bioprosthetic valves have limited durability because of structural valve deterioration. The main objective of this summary of experts participating in a virtual workshop was to propose standardized definitions for nonstructural and structural BVD and BVF following aortic or mitral biological valve replacement with the goal of facilitating research reporting and implementation of these terms in clinical practice. Definitions of structural BVF, based on valve reintervention or death, underestimate the true incidence of BVF. However, definitions solely based on the presence of high transprosthetic gradient at a given echocardiogram during follow-up overestimate the incidence of structural BVD and BVF. Definitions of aortic or mitral structural BVD must therefore include the confirmation by imaging of permanent structural changes to the leaflets alongside evidence of deterioration in valve hemodynamic function at echocardiography follow-up.

Original languageEnglish
JournalJournal of the American College of Cardiology
Volume80
Issue number5
Pages (from-to)545-561
Number of pages17
ISSN0735-1097
DOIs
Publication statusPublished - 2 Aug 2022

Bibliographical note

Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

    Research areas

  • Aortic Valve/diagnostic imaging, Aortic Valve Stenosis/surgery, Bioprosthesis/adverse effects, Heart Valve Diseases/surgery, Heart Valve Prosthesis/adverse effects, Humans, Mitral Valve/diagnostic imaging, Prosthesis Design, Prosthesis Failure, Transcatheter Aortic Valve Replacement/methods, Treatment Outcome

ID: 80001173