Increasing rates of obesity and metabolic syndrome, along with externally mounted valves, pose significant risks to the longevity of bioprosthetic valves by facilitating early structural deterioration.
Patient factors such as obesity and metabolic syndrome, along with valve design factors like external mounting, significantly contribute to early structural valve deterioration in bioprosthetic aortic valves.
BACKGROUND: With guidelines progressively recommending bioprosthetic aortic valves in younger patients, a greater emphasis is placed on structural valve deterioration (SVD) as an important clinical endpoint for both transcatheter and surgically implanted valves. However, SVD of bioprosthetic valves is a complex entity with varying definitions in the literature and a multifaceted pathogenesis. AIM: This review first aims to establish the most updated definitions of SVD as per the literature. We then explore the patient- and valve-related factors that play the greatest roles in facilitating early SVD. METHODS: A PubMed literature review was conducted to identify the relevant research in this field within the past two decades. CONCLUSION: Increasing rates of obesity and metabolic syndrome pose a significant risk to the longevity of bioprosthetic valves. Additionally, externally mounted valves have proven to sacrifice durability for superior haemodynamics. Bioprosthetic SVD continues to be a multifactorial issue that will require various patient- and valve-related factors to be addressed.
Tnay et al. (Tue,) conducted a review in Bioprosthetic structural valve deterioration. Patient- and valve-related factors (e.g., obesity, metabolic syndrome, externally mounted valves) was evaluated on Structural valve deterioration (SVD). Increasing rates of obesity and metabolic syndrome, along with externally mounted valves, pose significant risks to the longevity of bioprosthetic valves by facilitating early structural deterioration.