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Aortic Valve Replacement with Bioprosthesis By Dr Yugal K Mishra

                               
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Bioprosthetic valves are increasingly employed in patients with aortic stenosis. In comparison with mechanical valves, bioprosthetic valves are associated with a lower risk of thromboembolic events and require long-term anticoagulation. On the other hand, bioprosthetic valves have limited durability; the best current valves can be expected to degenerate within 10 to two decades, resulting in stenosis or maybe regurgitation. Surgical valve replacement is the current standard of maintain these patients. However, reoperative morbidity as well as mortality risk is considerable, not only because from the complexity of reoperation but also because several of these patients have comorbidities, specifically advanced age.

Transcatheter heart valve (THV) implantation intended for native valve aortic stenosis has evolved to be a viable, less invasive option to open heart surgery with selected patients. 6 Not too long ago, THV implantation within was unable surgically implanted bioprostheses possesses proven feasible. Here, we review what is known of the possible and challenges of valve-in-valve (VinV) implantation with patients with failing precise aortic bioprostheses.

Bioprosthetic Precise Aortic Valves
Bioprosthetic valves incorporate leaflets constructed from animal tissue. Xenografts usually are fashioned from porcine aortic valves, from more durable bovine pericardium, or seldom from porcine pericardium. Homografts usually are fashioned from human aortic valves. Tissue is normally preserved in glutaraldehyde, that cross-links collagen fibers, decreasing antigenicity and in vivo enzymatic destruction. Various proprietary anticalcification treatments may be used. Surgical bioprostheses may be stratified into stented as well as stentless valves.