The Annals of Thoracic Surgery, Vol 31, 274-276, Copyright © 1981 by The Society of Thoracic Surgeons
Spontaneous heterograft aortic valve failure
TM Grehl, MB O'Neil Jr, J Naifeh, A Dajee, EJ Hurley and T Riemenschneider
Glutaraldehyde-treated porcine aortic valve prostheses have been in
clinical use for ten years. The long-term durability of these valves
remains unknown although they have functioned well in most large clinical
series for more than five years. At the present time, several manufacturers
produce bioprostheses mounted on flexible stents. This report concerns the
failure of an Edwards porcine xenograft in the aortic position 15 months
following implantation. At reoperation, the right and left coronary
leaflets of the explanted valve were torn from the aortic wall. The loss of
wall integrity suggests that during the process of mounting the xenograft
on the flexible stent, the aortic walls of the bioprosthesis may have been
thinned beyond a critical point of maintenance of wall strength. The
pathological and clinical findings of similar cases are reviewed.
