On the basis of visual inspection, despite the new ThermaFix (Edwards Lifesciences) tissue treatment, the Perimount Magna pericardial valves calcified in vitro faster and more severely than did the Mosaic Ultra porcine valves, which demonstrated a more constant performance throughout the calcification process. Leaflet kinematics showed a progressive prolongation of opening and closing times for pericardial valves, leading to higher closing volume.

In the exercise situation pericardial valves demonstrated superior systolic function compared to porcine valves. Therefore pericardial valves have some advantage in active patients due to the lower gradients. Total energy loss remained constant during progressive calcification for both valves. Leaflet opening and closing is faster in porcine valves; clinical impact of these findings is not known. Diastolic performance is also important and should always be tested also in vivo.