Primary leaflet tear without dystrophic calcifications in a 25 years old Ionescu-Shiley pericardial valve in mitral position

Abstract

Despite its excellent hemodynamic performance, the Ionescu-Shiley bovine pericardial bioprosthesis was removed from clinical use in 1987 because of an unacceptable high incidence of primary structural deterioration of the valve, mainly related to its design. Few examples of very long-term durability of this prosthesis have been recently reported. In all these cases, the valve dysfunction was caused by primary severe dystrophic calcification and/or pannus formation. In contrast, we describe the unexpected 25-year longevity of a mitral Ionescu-Shiley bioprosthesis which failed due to primary tears of one cusp but without dystrophic changes.