Idiopathic perforation of a porcine aortic bioprosthesis in the aortic position

The report of a failure of glutaraldehyde-preserved porcine aortic xenograft bioprosthesis in the aortic position after 13 months is presented. Severe aortic regurgitation resulted from three "idiopathic" perforations in one of the cusps, and a linear tear in another cusp. Light and electron microscopy showed generalized degeneration of collagen thoughout the faulty valve. The absence of a platelet-fibrin coat on edges of the tear suggested a recent origin, compatible with cardiac catheter manipulation during unsuccessful attempts to cross the valve. The histopathologic data from this valve correlate with previously reported failures with formaldehyde preserved xenograft valves.