Fatigue-induced failure of the Ionescu-Shiley pericardial xenograft in the mitral position

A Case of 24 Years Longevity of an Ionescu-Shiley Bioprosthesis in the Mitral Position

“…Destruction of the leaflet may have occurred as a result of mechanical factors; such as friction or fatigue within the struts and leaflets, which lacked the neointima. 5,6…”

“…may have occurred as a result of mechanical factors; such as friction or fatigue within the struts and leafl ets, which lacked the neointima. 5,6 Schoen et al reported cuspal calcifi cation and defects clearly associated with commissural sutures ("alignment stitches") unique to this valve design. Additionally, gross cuspal thickening and mild stretching and microscopic deep fl uid insudation, separation of collagen bundles, and mononuclear infl ammation were observed within 7 years postoperatively.…”

Vincenzo Gallucci: Memories of a Surgeon, Scientist, and Teacher

“…10,11 Similar studies were subsequently also performed on pericardial xenografts, proposed as an alternative to porcine heterografts, evidencing that such devices were plagued by a high rate of mechanical failures mostly due to technical problems during valve manufacture. 12,13 The increasing clinical and pathologic experience in this field convinced Vincenzo Gallucci, with the patronage of the University of Padua, to organize the Second International Symposium on Cardiac Bioprostheses, which was held in Rome in 1982 ( Figure 3A). This meeting gathered the most authoritative experts to discuss issues and present personal experiences related to the use of bioprosthetic valves.…”

Durability of the Mitroflow Pericardial Prosthesis: Influence of Patient–Prosthesis Mismatch and New Anticalcification Treatment

“…rate of early mechanical failures mostly attributed to a faulty design confirmed by various clinical and pathological studies. [12][13][14][15] Based on such results, specific technical modifications have been included in the manufacturing process yielding a new generation of pericardial bioprostheses in which fatigue-induced failures have been significantly reduced. The MPB has been introduced clinically in 1982, and since then, many reports have subsequently documented an excellent overall early and late performance of such device in terms of both hemodynamic results and long-term durability.…”