Ionescu-Shiley valve failure II: Experience with 25 low-profile expiants

Walley, Virginia M.; Keon, Claudia A.; Khalili, Mandana; Moher, David; Campagna, Martine; Keon, Wilbert J.

doi:10.1016/0003-4975(92)91155-3

Cited by 17 publications

(10 citation statements)

References 11 publications

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“…Mechanical failures of the IS valve were associated with tears in the leaflets along the free edges near the top of the struts (Brais et al 1985; Schoen et al 1987; Walley et al 1992; Machida et al 2001), which agrees with this result (Fig. 7b).…”

Section: Discussionsupporting

confidence: 87%

Simulation of long-term fatigue damage in bioprosthetic heart valves: effects of leaflet and stent elastic properties

Martin

Sun

2013

Biomech Model Mechanobiol

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One of the major failure modes of bioprosthetic heart valves (BHVs) is noncalcific structural deterioration due to fatigue of the tissue leaflets; yet, the mechanisms of fatigue are not well understood. BHV durability is primarily assessed based on visual inspection of the leaflets following accelerated wear testing. In this study, we developed a computational framework to simulate BHV leaflet fatigue, which is both efficient and quantitative, making it an attractive alternative to traditional accelerated wear testing. We utilize a phenomenological soft tissue fatigue damage model developed previously to describe the stress softening and permanent set of the glutaraldehyde-treated bovine pericardium leaflets in BHVs subjected to cyclic loading. A parametric study was conducted to determine the effects of altered leaflet and stent elastic properties on the fatigue of the leaflets. The simulation results show that heterogeneity of the leaflet elastic properties, poor leaflet coaptation, and little stent-tip deflection may accelerate leaflet fatigue, which agrees with clinical findings. Therefore, the developed framework may be an invaluable tool for evaluating leaflet durability in new tissue valve designs, including traditional BHVs as well as new transcatheter valves.

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Section: Discussionsupporting

confidence: 87%

Simulation of long-term fatigue damage in bioprosthetic heart valves: effects of leaflet and stent elastic properties

Martin

Sun

2013

Biomech Model Mechanobiol

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“…Though hemodynamically superior to its predecessor, the Ionescu‐Shiley standard valve, it showed a tendency to early, likely design‐related failure within two to six years of implantation, and was therefore withdrawn from the market. Tissue degeneration, cusp tears, and calcification are modes of failure common to ISLP bioprosthetic valves 3 (and to all other glutaraldehyde‐ fixed bioprostheses), as seen in our case. In our case, however, the duration of implantation of more than 20 years is very interesting, since most ISLP valves failed within the first two to six years.…”

Section: Discussionsupporting

confidence: 58%

The Role of Pannus in the Longevity of an Ionescu-Shiley Pericardial Bioprosthesis

Butany¹,

Kesarwani²,

Yau

et al. 2006

J Cardiac Surgery

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As the population ages, bioprosthetic heart valves are increasingly being used to replace diseased native valves. Bioprosthetic valve durability depends on patient age and other factors, but rarely exceeds 15 years. Explanted bioprosthetic valves commonly show tissue degeneration, tears, and calcification. Host tissue overgrowth (pannus), to the extent of interfering with their function, is another finding in bioprostheses that have been in place for long periods. We present a case in which a bovine pericardial valve was explanted after more than 20 years of implantation. The longevity of this pericardial valve may have been related to excessive pannus growth, which most likely protected the valve from earlier failure.

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“…In cases where the valve was removed more than 5 years after implantation, a lower rate of cusp tears was reported and degenerative processes such as cusp calcification and tissue overgrowth were the predominant causes of valve dysfunction. [1] Some examples of extreme durability of the ISBP have been published recently both in aortic [2,3] and mitral positions. [4,5] However, in these reports, late valve failure was primarily related to severe dystrophic changes of the valve leaflets with major calcifications eventually leading to secondary tears and/or significant pannus formation.…”

Section: Discussionmentioning

confidence: 99%

Primary leaflet tear without dystrophic calcifications in a 25 years old Ionescu-Shiley pericardial valve in mitral position

Quessard¹,

Hammoudi²,

Kirsch

2015

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Despite its excellent hemodynamic performance, the Ionescu-Shiley bovine pericardial bioprosthesis was removed from clinical use in 1987 because of an unacceptable high incidence of primary structural deterioration of the valve, mainly related to its design. Few examples of very long-term durability of this prosthesis have been recently reported. In all these cases, the valve dysfunction was caused by primary severe dystrophic calcification and/or pannus formation. In contrast, we describe the unexpected 25-year longevity of a mitral Ionescu-Shiley bioprosthesis which failed due to primary tears of one cusp but without dystrophic changes.

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Ionescu-Shiley valve failure II: Experience with 25 low-profile expiants

Cited by 17 publications

References 11 publications

Simulation of long-term fatigue damage in bioprosthetic heart valves: effects of leaflet and stent elastic properties

Simulation of long-term fatigue damage in bioprosthetic heart valves: effects of leaflet and stent elastic properties

The Role of Pannus in the Longevity of an Ionescu-Shiley Pericardial Bioprosthesis

Primary leaflet tear without dystrophic calcifications in a 25 years old Ionescu-Shiley pericardial valve in mitral position

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