The influence of design on bioprosthetic valve durability.

Bioprosthetic heart valves have evolved over the years into remarkably useful and predictable devices. A number of specific designs have come and gone, and a few have remained. Many design changes were successful and many were not. This article describes the successes and failures of the various bioprosthetic valve designs and details the specific reasons why a particular design change succeeded or failed to improve bioprosthetic valve performance.