Standardized Definitions for Bioprosthetic Valve Dysfunction Following Aortic or Mitral Valve Replacement
Journal of the American College of Cardiology, vol. 80, pp. 545–561
Abstract
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.
Authors 36
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Philippe Pîbarot corresponding
Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval
Affiliation as printed
Department of Medicine, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada. Electronic address: philippe.pibarot@med.ulaval.ca
Department of Medicine, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
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Affiliation as printed
University of Pennsylvania, Philadelphia, Pennsylvania, USA
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United States Food and Drug Administration
Affiliation as printed
U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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Columbia University Irving Medical Center · Columbia University
Affiliation as printed
Department of Medicine, Columbia University Medical Center, New York, New York, USA
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University of Washington · University of Washington Medical Center
Affiliation as printed
Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
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Affiliation as printed
Beaumont Hospital, Royal Oak, Royal Oak, Michigan, USA
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Guy's and St Thomas' NHS Foundation Trust · University of Cambridge · King's College Hospital
Affiliation as printed
Guy's and St Thomas' NHS Foundation Trust, Cambridge University and King's College Hospital, London, United Kingdom
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Affiliation as printed
BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
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Affiliation as printed
Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
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Affiliation as printed
Yale School of Medicine, New Haven, Connecticut, USA
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Georgetown University · MedStar Heart & Vascular Institute
Affiliation as printed
MedStar Heart and Vascular Institute and Georgetown University, Washington, DC, USA
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Affiliation as printed
Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
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Affiliation as printed
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Hôpital Cardiologique du Haut-Lévêque
Affiliation as printed
Haut-Leveque Cardiologic Hospital, Bordeaux University, Pessac, France
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Sunnybrook Health Science Centre · University of Toronto
Affiliation as printed
Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Copenhagen University Hospital · Rigshospitalet
Affiliation as printed
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco"
Affiliation as printed
A.O.U. Policlinico "G. Rodolico - San Marco," Catania, Italy
A.O.U. Policlinico "G. Rodolico – San Marco," Catania, Italy
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Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval
Affiliation as printed
Department of Medicine, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
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Morristown Medical Center · Atlantic Health System
Affiliation as printed
Department of Cardiovascular Medicine, Morristown Medical Center/Atlantic Health System, Morristown, New York, USA
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Brigham and Women's Hospital · Harvard University
Affiliation as printed
Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Tel Aviv University · Wolfson Medical Center
Affiliation as printed
Edith Wolfson Medical Center, Holon, and Tel-Aviv University, Tel-Aviv, Israel
Edith Wolfson Medical Center, Holon,
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St. Paul's Hospital · Vancouver General Hospital
Affiliation as printed
Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada;
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University of Michigan · Michigan Medicine
Affiliation as printed
University of Michigan Health, Ann Arbor, Michigan, USA
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St. Paul's Hospital · Vancouver General Hospital
Affiliation as printed
Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada;
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Columbia University Irving Medical Center · Columbia University
Affiliation as printed
Department of Medicine, Columbia University Medical Center, New York, New York, USA
Department of Medicine, Columbia University Medical Center, New York, New York, USA;
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Morristown Medical Center · Atlantic Health System
Affiliation as printed
Department of Cardiovascular Medicine, Morristown Medical Center/Atlantic Health System, Morristown, New York, USA
Department of Cardiovascular Medicine, Morristown Medical Center/Atlantic Health System, Morristown, New York, USA;
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Affiliation as printed
Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, Texas, USA
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Affiliation as printed
Cardiovascular Center, Bad Oeynhausen, Germany
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Brigham and Women's Hospital · Harvard University
Affiliation as printed
Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA;
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Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval
Affiliation as printed
Department of Medicine, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
Department of Medicine, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada;
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Affiliation as printed
Baylor Scott and White, The Heart Hospital, Plano, Texas, USA
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Centre Hospitalier Universitaire de Liège
Affiliation as printed
CHU Stat Tilman, Liège, Belgium
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Affiliation as printed
Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
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Affiliation as printed
Hart Long Centrum Leiden, Leiden University, Leiden, the Netherlands
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Affiliation as printed
Baylor Scott and White, The Heart Hospital, Plano, Texas, USA
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Columbia University Irving Medical Center · Columbia University
Affiliation as printed
Department of Medicine, Columbia University Medical Center, New York, New York, USA
Department of Medicine, Columbia University Medical Center, New York, New York, USA;
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