[en] Bioprosthetic valve dysfunction (BVD) and bioprosthetic valve failure (BVF) may be caused by structural or nonstructural valve dysfunction. Both surgical and transcatheter bioprosthetic valves have limited durability because of structural valve deterioration. The main objective of this summary of experts participating in a virtual workshop was to propose standardized definitions for nonstructural and structural BVD and BVF following aortic or mitral biological valve replacement with the goal of facilitating research reporting and implementation of these terms in clinical practice. Definitions of structural BVF, based on valve reintervention or death, underestimate the true incidence of BVF. However, definitions solely based on the presence of high transprosthetic gradient at a given echocardiogram during follow-up overestimate the incidence of structural BVD and BVF. Definitions of aortic or mitral structural BVD must therefore include the confirmation by imaging of permanent structural changes to the leaflets alongside evidence of deterioration in valve hemodynamic function at echocardiography follow-up.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Pibarot, Philippe; Department of Medicine, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada. Electronic address: philippe.pibarot@med.ulaval.ca
Herrmann, Howard C ; University of Pennsylvania, Philadelphia, Pennsylvania, USA
Wu, Changfu; U.S. Food and Drug Administration, Silver Spring, Maryland, USA
Hahn, Rebecca T ; Department of Medicine, Columbia University Medical Center, New York, New York, USA
Otto, Catherine M; Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
Abbas, Amr E; Beaumont Hospital, Royal Oak, Royal Oak, Michigan, USA
Chambers, John; Guy's and St Thomas' NHS Foundation Trust, Cambridge University and King's College Hospital, London, United Kingdom
Dweck, Marc R; BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
Leipsic, Jonathon A; Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
Simonato, Matheus; Yale School of Medicine, New Haven, Connecticut, USA
Rogers, Toby; MedStar Heart and Vascular Institute and Georgetown University, Washington, DC, USA
Sathananthan, Janarthanan; Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
Guerrero, Mayra; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
Ternacle, Julien ; Haut-Leveque Cardiologic Hospital, Bordeaux University, Pessac, France
Wijeysundera, Harindra C; Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Sondergaard, Lars; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Barbanti, Marco ; A.O.U. Policlinico "G. Rodolico - San Marco," Catania, Italy
Salaun, Erwan; Department of Medicine, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
Généreux, Philippe; Department of Cardiovascular Medicine, Morristown Medical Center/Atlantic Health System, Morristown, New York, USA
Kaneko, Tsuyoshi; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Landes, Uri; Edith Wolfson Medical Center, Holon, and Tel-Aviv University, Tel-Aviv, Israel
Wood, David A; Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
Deeb, G Michael; University of Michigan Health, Ann Arbor, Michigan, USA
Sellers, Stephanie L; Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
Lewis, John; Heart Valve Voice US, Washington, DC, USA
Madhavan, Mahesh; Department of Medicine, Columbia University Medical Center, New York, New York, USA
Gillam, Linda; Department of Cardiovascular Medicine, Morristown Medical Center/Atlantic Health System, Morristown, New York, USA
Reardon, Michael; Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, Texas, USA
Bleiziffer, Sabine; Cardiovascular Center, Bad Oeynhausen, Germany
O'Gara, Patrick T; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Rodés-Cabau, Josep; Department of Medicine, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
Grayburn, Paul A; Baylor Scott and White, The Heart Hospital, Plano, Texas, USA
Lancellotti, Patrizio ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Thourani, Vinod H; Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
Bax, Jeroen J; Hart Long Centrum Leiden, Leiden University, Leiden, the Netherlands
Mack, Michael J; Baylor Scott and White, The Heart Hospital, Plano, Texas, USA
Leon, Martin B; Department of Medicine, Columbia University Medical Center, New York, New York, USA
Dr Pibarot has received funding from Edwards Lifesciences, Medtronic, Pi-Cardia, and Cardiac Phoenix for echocardiography core laboratory analyses and research studies in the field of transcatheter valve therapies, for which he received no personal compensation; and has received lecture fees from Edwards Lifesciences and Medtronic. Dr Herrmann has received institutional research funding from Abbott, Boston Scientific, Edwards Lifesciences, Highlife, Medtronic, and WL Gore; has received consulting fees from Edwards Lifesciences, Medtronic, Wells Fargo, and WL Gore; and has equity in Holistick Medical and Microinterventional Devices. Dr Hahn has received speaker fees from Abbott Structural, Edwards Lifesciences, and Philips Healthcare; has institutional consulting contracts for which she receives no direct compensation with Abbott Structural, Boston Scientific, Edwards Lifesciences, Medtronic and Novartis; and has equity in Navigate. Dr Abbas has received research grants and consulting fees from Edwards Lifesciences. Dr Dweck has served as a consultant to Edwards Lifesciences and Medtronic; has received research funding from Edwards Lifesciences and Medtronic; and has received speaking fees from NVT. Dr Leipsic has served as a consultant for Circle CVI and MVRX; and has received institutional funding for CT core laboratory analyses from Edwards Lifesciences, Neovasc, Abbott, Medtronic, Boston Scientific, PI Cardia, and Conformal. Dr Rogers has served as a consultant and physician proctor for Edwards Lifesciences and Medtronic; has served as an advisory board member for Medtronic; and holds equity interest in Transmural Systems. Dr Sathananthan has served as a consultant to Edwards Lifesciences and Medtronic; has received research funding from Edwards Lifesciences and Medtronic; and has received speaking fees from NVT. Dr Guerrero has received institutional research grant support from Edwards Lifesciences. Dr Ternacle has served as a consultant for Philips Healthcare and Abbott Medical. Dr Barbanti has served as a consultant for Edwards Lifesciences and Boston Scientific. Dr Généreux has served as a consultant and advisor for and received speaker fees from Abbott Vascular, Abiomed, BioTrace Medical, and Medtronic; has served as a consultant for Boston Scientific, GE Healthcare, iRhythm Technologies, Opsens, Siemens, and Teleflex; has served as a consultant, PI Eclipse Trial, for Cardiovascular System Inc; has served as a consultant, advisor, and proctor for and received speaker fees and research grant from Edwards LifeSciences for the PI EARLY-TAVR and PI PROGRESS trials; has served as a consultant for and has equity in Pi-Cardia, Puzzle Medical, Saranas, and Soundbite Medical Inc; has served as a consultant for and received speaker fees from Shockwave; and has served as a consultant for the PI Feasibility study for 4C Medical. Dr Kaneko has served as a consultant for Edwards Lifesciences, Medtronic, and Abbott Structural. Dr Wood has served as a consultant to and his institution (CCI-CIC) receives grant support from Edwards Lifesciences, Abbott Vascular, and Medtronic. Dr Gillam has served as a consultant to Philips and Bracco; is an advisory board member for Edwards Lifesciences; and has core lab contracts with Edwards Lifesciences, Medtronic, and Abbott for which she receives no direct compensation. Dr Reardon has served as a consultant for Medtronic, Boston Scientific, Abbott Medical, and Gore Medical; all fees for such are to his department. Dr Rodes-Cabau has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific. Dr Thourani has performed consulting/research for Abbott Vascular, Boston Scientific, Cryolife, Edwards Lifesciences, Medtronic, and Shockwave. Dr Bax’s institution (Department of Cardiology, LUMC, the Netherlands) has received research grants from Medtronic, Biotronik, Edwards Lifesciences, and Boston Scientific. Dr Mack has served as a co-principal investigator for clinical trials for Abbott and Edwards Lifesciences; and has served as study chair for a trial for Medtronic; all roles were uncompensated. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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