Bioprosthetic heart valves: modes of failure.

Valve replacement started in 1960, with the surgeon now having a significant variety of prosthetic heart valves from which to choose. These valves are broadly divided into mechanical heart valves (MHV) and bioprosthetic heart valves (BHV). Improvements in the performance and ease of usage of BHV without the need for anticoagulant therapy are among the desired features of BHV and hence the increasingly preferred choice over their mechanical counterparts. However, with increased use the post-implantation complications have become more apparent, and these include: calcification, cusp tears, pannus growth, infective endocarditis, valve thrombosis and other factors specific to valve type. In this review we describe these complications in order to bring awareness among surgeons, clinicians and pathologists. Diagnosis, treatment and preventive measures, if taken in a timely manner, can help reduce their impact and further enhance the quality of life of patients with prosthetic heart valves.