Postimplant biological aortic prosthesis degeneration: Challenges in transcatheter valve implants

Elham Bidar, Thierry Folliguet, Jolanda Kluin, Claudio Muneretto, Alessandro Parolari, Fabio Barili, Piotr Suwalski, Nikolaos Bonaros, Prakash Punjabi, Rafa Sadaba, Michele De Bonis, Nawwar Al-Attar, Jean Francois Obadia, Martin Czerny, Malakh Shrestha, Rachid Zegdi, Ehsan Natour, Roberto Lorusso

Research output: Contribution to journalArticlepeer-review


Surgical aortic valve replacement (SAVR) is highly effective and can be achieved with relatively low risk in patients with severe aortic stenosis. Bioprostheses have been used most frequently during the past 60 years. However, the function of biological valves usually declines after 10-15 years from implant when structural valve degeneration occurs often mandating a reoperation once valve dysfunction becomes haemodynamically significant. Known for many years by surgeons and cardiologists taking care of patients with SAVR, the issue of postimplant structural valve degeneration has been recently highlighted also in patients with transcatheter aortic valve implant (TAVI). There is growing concern that TAVI valves exhibit structural valve degeneration due to inherent challenges of the deployment mode. The impact on postimplant degeneration of TAVI valves compared to SAVR has still to be understood and defined. Based on the ongoing process of expanding TAVI indications, several potential shortcomings and caveats, learned during the last 60 years of SAVR experience, should be taken into consideration to refine this technique.

Original languageEnglish
Pages (from-to)191-200
Number of pages10
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number2
Publication statusPublished - Feb 1 2019


  • Aortic valve replacement
  • Structural valve degeneration
  • Transcatheter aortic valve degeneration
  • Transcatheter aortic valve implant

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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