Integrity of mechanical aortic valve prostheses explanted after 27 and 23 years

We describe 2 cases of mechanical aortic valve endocarditis and the influence on clinical outcome and prostheses material integrity. One patient required extensive reconstruction due to active endocarditis leading to a "rocking valve". The second case was caused by late aortic dissection following endocarditis. Both valve prostheses showed remarkable material quality and performance in functional assessment and high resolution scanning electron microscopic evaluation after 27 and 23 years of service.