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J Thorac Cardiovasc Surg 2009;138:1448-1450
© 2009 The American Association for Thoracic Surgery

Brief Research Report

Comparison of the quantity of calcific deposits in bovine pericardial bioprostheses in the mitral and aortic valve positions in the same patient late after double-valve replacement

^a Department of Internal Medicine (Division of Cardiology), Baylor University Medical Center, Dallas, Tex
^b Department of Pathology, Baylor University Medical Center, Dallas, Tex
^c Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, Tex
^d Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Tex

Received for publication January 29, 2009; accepted for publication February 8, 2009.

^_* Address for reprints: William C. Roberts, MD, Baylor Heart and Vascular Institute, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246. (Email: wc.roberts@baylorhealth.edu).

The first 20% of the full text of this article appears below.

	Introduction

 
Among patients undergoing cardiac valve replacement, the aortic valve is most commonly replaced, the mitral valve next, and, infrequently, both the mitral and aortic valves. When the latter situation occurs and when the substitute valves inserted are both bioprostheses, it is possible to compare the rates of degenerative change because one bioprosthesis serves as a control for the other. In 1983, Warnes and associates¹ reported on 5 patients with porcine bioprostheses in both the mitral and aortic valve positions from 18 to 107 months, and in each of the 4 patients in which the bioprosthesis was in place for greater than 18 months, the quantity of calcific deposits on the cusps of the bioprosthesis in the mitral valve position was much greater than that on the prosthesis in the aortic valve position. The present report was prompted by observing a patient who had a bovine parietal pericardial bioprosthesis in both the mitral and aortic positions explanted after they had been in place for 77 months; the quantity of calcium in the bioprosthesis in the aortic valve position was massive, and that in the bioprosthesis in the mitral position was minimal.

	Clinical Summary

 
A patient, who was born on March 25, 1949, had acute rheumatic fever in childhood and hypothyroidism since age 20 years. She was in her usual good health until April . . . [Full Text of this Article]