Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and Management

Bioprosthetic aortic valve degeneration (BAVD) is a significant clinical concern following both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). The increasing use of bioprosthetic valves in aortic valve replacement in younger patients and the subsequent ri...

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Main Authors: Nadera N. Bismee, Niloofar Javadi, Ahmed Khedr, Fatma Omar, Kamal Awad, Mohammed Tiseer Abbas, Isabel G. Scalia, Milagros Pereyra, George Bcharah, Juan M. Farina, Chadi Ayoub, Kristen A. Sell-Dottin, Reza Arsanjani
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Journal of Cardiovascular Development and Disease
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Online Access:https://www.mdpi.com/2308-3425/11/12/384
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author Nadera N. Bismee
Niloofar Javadi
Ahmed Khedr
Fatma Omar
Kamal Awad
Mohammed Tiseer Abbas
Isabel G. Scalia
Milagros Pereyra
George Bcharah
Juan M. Farina
Chadi Ayoub
Kristen A. Sell-Dottin
Reza Arsanjani
author_facet Nadera N. Bismee
Niloofar Javadi
Ahmed Khedr
Fatma Omar
Kamal Awad
Mohammed Tiseer Abbas
Isabel G. Scalia
Milagros Pereyra
George Bcharah
Juan M. Farina
Chadi Ayoub
Kristen A. Sell-Dottin
Reza Arsanjani
author_sort Nadera N. Bismee
collection DOAJ
description Bioprosthetic aortic valve degeneration (BAVD) is a significant clinical concern following both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). The increasing use of bioprosthetic valves in aortic valve replacement in younger patients and the subsequent rise in cases of BAVD are acknowledged in this review which aims to provide a comprehensive overview of the incidence, diagnosis, predictors, and management of BAVD. Based on a thorough review of the existing literature, this article provides an updated overview of the biological mechanisms underlying valve degeneration, including calcification, structural deterioration, and inflammatory processes and addresses the various risk factors contributing to BAVD, such as patient demographics, comorbidities, and procedural variables. The difficulties in early detection and accurate diagnosis of BAVD are discussed with an emphasis on the need for improved imaging techniques. The incidence and progression of BAVD in patients undergoing TAVR versus SAVR are compared, providing insights into the differences and similarities between the two procedures and procedural impacts on valve longevity. The current strategies for managing BAVD, including re-intervention options of redo surgery and valve-in-valve TAVR, along with emerging treatments are discussed. The controversies in the existing literature are highlighted to offer directions for future investigations to enhance the understanding and management of BAVD.
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spelling doaj-art-dff0497027bf4c3ab4b619b36fc100ab2025-08-20T02:00:42ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-11-01111238410.3390/jcdd11120384Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and ManagementNadera N. Bismee0Niloofar Javadi1Ahmed Khedr2Fatma Omar3Kamal Awad4Mohammed Tiseer Abbas5Isabel G. Scalia6Milagros Pereyra7George Bcharah8Juan M. Farina9Chadi Ayoub10Kristen A. Sell-Dottin11Reza Arsanjani12Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Surgery, Mayo Clinic, Phoenix, AZ 85054, USAMayo Clinic Alix School of Medicine, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USAMayo Clinic Alix School of Medicine, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Surgery, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USABioprosthetic aortic valve degeneration (BAVD) is a significant clinical concern following both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). The increasing use of bioprosthetic valves in aortic valve replacement in younger patients and the subsequent rise in cases of BAVD are acknowledged in this review which aims to provide a comprehensive overview of the incidence, diagnosis, predictors, and management of BAVD. Based on a thorough review of the existing literature, this article provides an updated overview of the biological mechanisms underlying valve degeneration, including calcification, structural deterioration, and inflammatory processes and addresses the various risk factors contributing to BAVD, such as patient demographics, comorbidities, and procedural variables. The difficulties in early detection and accurate diagnosis of BAVD are discussed with an emphasis on the need for improved imaging techniques. The incidence and progression of BAVD in patients undergoing TAVR versus SAVR are compared, providing insights into the differences and similarities between the two procedures and procedural impacts on valve longevity. The current strategies for managing BAVD, including re-intervention options of redo surgery and valve-in-valve TAVR, along with emerging treatments are discussed. The controversies in the existing literature are highlighted to offer directions for future investigations to enhance the understanding and management of BAVD.https://www.mdpi.com/2308-3425/11/12/384bioprosthetic aortic valvestructural valve degenerationaortic stenosisaortic valve replacement
spellingShingle Nadera N. Bismee
Niloofar Javadi
Ahmed Khedr
Fatma Omar
Kamal Awad
Mohammed Tiseer Abbas
Isabel G. Scalia
Milagros Pereyra
George Bcharah
Juan M. Farina
Chadi Ayoub
Kristen A. Sell-Dottin
Reza Arsanjani
Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and Management
Journal of Cardiovascular Development and Disease
bioprosthetic aortic valve
structural valve degeneration
aortic stenosis
aortic valve replacement
title Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and Management
title_full Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and Management
title_fullStr Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and Management
title_full_unstemmed Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and Management
title_short Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and Management
title_sort bioprosthetic aortic valve degeneration after tavr and savr incidence diagnosis predictors and management
topic bioprosthetic aortic valve
structural valve degeneration
aortic stenosis
aortic valve replacement
url https://www.mdpi.com/2308-3425/11/12/384
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