This comprehensive review of bioprosthetic valves is the third collection of articles read before the International Symposium of Cardiac Bioprosthesis. The current edition, reporting on the symposium held in London, is remarkably well organized and edited.
The articles cover the spectrum of the use of bioprosthetic valve material, from aortic hemograft replacement, porcine valves, pericardial valves, and various aortic conduits containing different valves, to the experimental replacement of the tricuspid valve by orthotopic transplantation. Modes of valve failure are presented, and the problems of infective endocarditis and the role of anticoagulation therapy are discussed. It is apparent that most porcine valves are hemodynamically acceptable and that pericardial valves have even better hemodynamic characteristics. The major concern remains the long-term durability of these valves. Continued modification of stent mounts and research to prevent calcification and reduce tensile and shear forces on the valve leaflets offer a modicum of hope that these